Provider Demographics
NPI:1033521737
Name:NAVAL HEALTH CLINIC CORPUS CHRISTI
Entity Type:Organization
Organization Name:NAVAL HEALTH CLINIC CORPUS CHRISTI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUMED UBO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:CONDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-401-3643
Mailing Address - Street 1:NAVAL HEALTH CLINIC CORPUS CHRISTI
Mailing Address - Street 2:10651 E ST STE 2031
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78419-5130
Mailing Address - Country:US
Mailing Address - Phone:361-961-2260
Mailing Address - Fax:361-961-3830
Practice Address - Street 1:10651 E ST BLDG H100
Practice Address - Street 2:NAVAL HEALTH CLINIC CORPUS CHRISTI
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78419
Practice Address - Country:US
Practice Address - Phone:361-961-2260
Practice Address - Fax:361-961-3264
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAVAL HEALTH CLINIC CORPUS CHRISTI
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-29
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2145995OtherPK