Provider Demographics
NPI: | 1366495012 |
---|---|
Name: | BAY AREA HEALTHCARE GROUP, LTD. |
Entity Type: | Organization |
Organization Name: | BAY AREA HEALTHCARE GROUP, LTD. |
Other - Org Name: | CORPUS CHRISTI MEDICAL CENTER |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CFO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CHRIS |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | NICOSIA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 361-878-1101 |
Mailing Address - Street 1: | PO BOX 8991 |
Mailing Address - Street 2: | 3315 ALAMEDA |
Mailing Address - City: | CORPUS CHRISTI |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78468-8991 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 361-761-1000 |
Mailing Address - Fax: | 361-857-5960 |
Practice Address - Street 1: | 7101 S PADRE ISLAND DR |
Practice Address - Street 2: | |
Practice Address - City: | CORPUS CHRISTI |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78412-4913 |
Practice Address - Country: | US |
Practice Address - Phone: | 361-761-1000 |
Practice Address - Fax: | 361-857-5960 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-05-17 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QA1903X | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |