Provider Demographics
NPI:1720541410
Name:CHRISTUS HEALTH ARK-LA-TEX
Entity Type:Organization
Organization Name:CHRISTUS HEALTH ARK-LA-TEX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUNDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-614-2003
Mailing Address - Street 1:2604 SAINT MICHAEL DR STE 238
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-2378
Mailing Address - Country:US
Mailing Address - Phone:903-614-8500
Mailing Address - Fax:
Practice Address - Street 1:5002 COWHORN CREEK RD STE 3218
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-9766
Practice Address - Country:US
Practice Address - Phone:903-614-8500
Practice Address - Fax:903-614-8530
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHRISTUS HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty