Provider Demographics
NPI:1699893503
Name:COASTAL SURGICAL GROUP
Entity type:Organization
Organization Name:COASTAL SURGICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANIBAL
Authorized Official - Middle Name:R
Authorized Official - Last Name:HADAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-922-5550
Mailing Address - Street 1:150 FM 1959 RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77034-5491
Mailing Address - Country:US
Mailing Address - Phone:281-922-5550
Mailing Address - Fax:281-481-8910
Practice Address - Street 1:150 FM 1959 RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-5491
Practice Address - Country:US
Practice Address - Phone:281-922-5550
Practice Address - Fax:281-481-8910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00F73LMedicare PIN