Provider Demographics
NPI:1871127068
Name:COASTAL FAMILY CARE LLC
Entity type:Organization
Organization Name:COASTAL FAMILY CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYZA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:GARZA-GEROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-376-6851
Mailing Address - Street 1:1000 S TEXAS BLVD
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-7058
Mailing Address - Country:US
Mailing Address - Phone:956-520-8558
Mailing Address - Fax:956-520-8557
Practice Address - Street 1:1000 S TEXAS BLVD
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-7058
Practice Address - Country:US
Practice Address - Phone:956-520-8558
Practice Address - Fax:956-520-8557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care