Provider Demographics
NPI:1780867390
Name:CHRISTUS SANTA ROSA HEALTHCARE
Entity Type:Organization
Organization Name:CHRISTUS SANTA ROSA HEALTHCARE
Other - Org Name:CHRISTUS SANTA ROSA HOSPITAL - NEW BRAUNFELS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-704-2624
Mailing Address - Street 1:PO BOX 280
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78291-0280
Mailing Address - Country:US
Mailing Address - Phone:210-704-3907
Mailing Address - Fax:210-704-3758
Practice Address - Street 1:600 N UNION
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4194
Practice Address - Country:US
Practice Address - Phone:830-606-9111
Practice Address - Fax:830-643-6174
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHRISTUS SANTA ROSA HEALTH CARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-06
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000415282N00000X
TX000339282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX020844901Medicaid
TXHH0403OtherBLUE CROSS BLUE SHIELD
TXHH0403OtherBLUE CROSS BLUE SHIELD
450237Medicare UPIN
450237Medicare Oscar/Certification