Provider Demographics
NPI:1447212121
Name:CHRISTUS SANTA ROSA OUTPATIENT SURGERY - NEW BRAUNFELS, LP
Entity Type:Organization
Organization Name:CHRISTUS SANTA ROSA OUTPATIENT SURGERY - NEW BRAUNFELS, LP
Other - Org Name:CHRISTUS PHYSICIANS SURGERY CENTER - NEW BRAUNFELS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:K
Authorized Official - Last Name:RUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-282-2637
Mailing Address - Street 1:1738 E COMMON ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-3156
Mailing Address - Country:US
Mailing Address - Phone:830-643-8600
Mailing Address - Fax:830-643-0444
Practice Address - Street 1:1738 E COMMON ST
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3156
Practice Address - Country:US
Practice Address - Phone:830-643-8600
Practice Address - Fax:830-643-0444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX130014261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX209083901Medicaid
ASC396Medicare PIN