Provider Demographics
NPI:1518052190
Name:CORPUS CHRISTI HOSPITALISTS, PLLC
Entity Type:Organization
Organization Name:CORPUS CHRISTI HOSPITALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-877-6986
Mailing Address - Street 1:PO BOX 60465
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78466-0465
Mailing Address - Country:US
Mailing Address - Phone:361-877-6986
Mailing Address - Fax:361-857-5960
Practice Address - Street 1:3315 SOUTH ALAMEDA
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411
Practice Address - Country:US
Practice Address - Phone:361-857-1501
Practice Address - Fax:361-857-5960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1816207R00000X
TXM2669207RN0300X
TXL1828208M00000X
TXM1999208M00000X
TXM7127208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXM2669OtherPHYSICIAN PERMIT
TXN1816OtherPHYSICIAN PERMIT
TXN5607OtherPHYSICIAN PERMIT
TXM7127OtherPHYSICIAN PERMIT
TXN2319OtherPHYSICIAN PERMIT
TX00X193Medicare PIN
TXN1816OtherPHYSICIAN PERMIT
TXI44412Medicare UPIN