Provider Demographics
NPI:1073642575
Name:CORPUS CHRISTI BETTER HEALTH PA
Entity Type:Organization
Organization Name:CORPUS CHRISTI BETTER HEALTH PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SOCORRO
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-993-2020
Mailing Address - Street 1:5833 SPOHN DR STE 101
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4135
Mailing Address - Country:US
Mailing Address - Phone:361-993-2020
Mailing Address - Fax:361-993-0515
Practice Address - Street 1:5833 SPOHN DR STE 101
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4135
Practice Address - Country:US
Practice Address - Phone:361-993-2020
Practice Address - Fax:361-993-0515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty