Provider Demographics
NPI:1275945776
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:HECTOR
Authorized Official - Middle Name:CHIEF DHA POSC
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-536-6650
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:361-516-6455
Mailing Address - Fax:361-516-6109
Practice Address - Street 1:730 FORRESTAL ST BLDG 3775
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78363
Practice Address - Country:US
Practice Address - Phone:361-516-6455
Practice Address - Fax:361-516-6109
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAVAL HEALTH CLINIC CORPUS CHRISTI
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-02
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2146031OtherPK