Provider Demographics
NPI:1043289804
Name:CHRISTUS SPOHN HEALTH SYSTEM CORPORATION
Entity Type:Organization
Organization Name:CHRISTUS SPOHN HEALTH SYSTEM CORPORATION
Other - Org Name:CHRISTUS SPOHN FAMILY HEALTH CENTER FREER
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 1:111 E RILEY ST
Practice Address - Street 2:
Practice Address - City:FREER
Practice Address - State:TX
Practice Address - Zip Code:78357-1830
Practice Address - Country:US
Practice Address - Phone:361-394-7311
Practice Address - Fax:361-394-7158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Multi-Specialty
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0096HZOtherBLUE CROSS
TX173157202Medicaid
TX173157201Medicaid
458855Medicare Oscar/Certification