Provider Demographics
NPI:1639197569
Name:CHRISTUS SPOHN FAMILY HEALTH CENTER - PADRE ISLAND
Entity Type:Organization
Organization Name:CHRISTUS SPOHN FAMILY HEALTH CENTER - PADRE ISLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-949-7660
Mailing Address - Street 1:14202 S PADRE ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-6030
Mailing Address - Country:US
Mailing Address - Phone:361-949-7660
Mailing Address - Fax:
Practice Address - Street 1:14202 S PADRE ISLAND DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418-6030
Practice Address - Country:US
Practice Address - Phone:361-949-7660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty