Provider Demographics
NPI:1003885641
Name:CHRISTUS SPOHN HEALTH SYSTEM CORPORATION
Entity Type:Organization
Organization Name:CHRISTUS SPOHN HEALTH SYSTEM CORPORATION
Other - Org Name:CHRISTUS SPOHN HOSPITAL ALICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OSBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-288-2222
Mailing Address - Street 1:PO BOX 847899
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7899
Mailing Address - Country:US
Mailing Address - Phone:800-756-7999
Mailing Address - Fax:469-282-1999
Practice Address - Street 1:2500 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-4169
Practice Address - Country:US
Practice Address - Phone:361-664-4376
Practice Address - Fax:361-668-2251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-16
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA1903X
TX006894282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX094222901Medicaid
TXHH0969OtherBLUE CROSS
LA1708712Medicaid
NMB1613Medicaid
MN600933600Medicaid
OK100701020BMedicaid
IN200265360AMedicaid
AZ710617Medicaid
TX094222902Medicaid
TX=========-41OtherUNITED HEALTH PLAN
TX=========001OtherTRICARE
TX094222902Medicaid
TX094222901Medicaid
TX=========-41OtherUNITED HEALTH PLAN