Provider Demographics
NPI:1093783391
Name:CHRISTUS SPOHN HEALTH SYSTEM CORPORATION
Entity Type:Organization
Organization Name:CHRISTUS SPOHN HEALTH SYSTEM CORPORATION
Other - Org Name:CHRISTUS SPOHN HOSPITAL KLEBERG
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 1:1311 GENERAL CAVAZOS BLVD
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78363-7197
Practice Address - Country:US
Practice Address - Phone:361-595-1661
Practice Address - Fax:361-595-5005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA1903X
TX000216282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136436604Medicaid
TXHH0359OtherBLUE CROSS
CAXHSP42260Medicaid
NM000A4183Medicaid
TX136436606Medicaid
LA1763896Medicaid
TX450163OtherUNITED HEALTH
CAXHSP32260Medicaid
IA0955302Medicaid
WA3015039Medicaid
TX=========003OtherTRICARE
NM000A4183Medicaid
CAXHSP42260Medicaid