Provider Demographics
NPI:1073558912
Name:CHRISTUS SANTA ROSA SURGERY CENTER L.L.P.
Entity Type:Organization
Organization Name:CHRISTUS SANTA ROSA SURGERY CENTER L.L.P.
Other - Org Name:CHRISTUS SANTA ROSA SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-293-4400
Mailing Address - Street 1:2833 BABCOCK RD
Mailing Address - Street 2:TOWER II, SUITE 100
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5390
Mailing Address - Country:US
Mailing Address - Phone:210-293-4400
Mailing Address - Fax:210-568-6597
Practice Address - Street 1:2833 BABCOCK RD
Practice Address - Street 2:TOWER II, SUITE 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5390
Practice Address - Country:US
Practice Address - Phone:210-293-4400
Practice Address - Fax:210-568-6597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008059261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX969602167OtherBLUE LINK
TX7885153OtherAETNA
TX169742701Medicaid
TXHH0258AOtherBLUE CROSS OF TEXAS
TX169742701Medicaid