Provider Demographics
NPI:1487656757
Name:CHRISTUS HEALTH GULF COAST
Entity Type:Organization
Organization Name:CHRISTUS HEALTH GULF COAST
Other - Org Name:CHRISTUS ST. JOHN HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:GENERALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-333-5503
Mailing Address - Street 1:18300 SAINT JOHN DR
Mailing Address - Street 2:
Mailing Address - City:NASSAU BAY
Mailing Address - State:TX
Mailing Address - Zip Code:77058-6302
Mailing Address - Country:US
Mailing Address - Phone:713-657-7341
Mailing Address - Fax:713-657-7106
Practice Address - Street 1:18300 SAINT JOHN DR
Practice Address - Street 2:
Practice Address - City:NASSAU BAY
Practice Address - State:TX
Practice Address - Zip Code:77058-6302
Practice Address - Country:US
Practice Address - Phone:713-657-7341
Practice Address - Fax:713-657-7106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000600273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45T709Medicare ID - Type UnspecifiedREHAB PROVIDER NUMBER