Provider Demographics
NPI:1811191984
Name:NAVAL AMBULATORY CARE CENTER,CORPUS CHRISTI, TEXAS
Entity Type:Organization
Organization Name:NAVAL AMBULATORY CARE CENTER,CORPUS CHRISTI, TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALS COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:VILLAGOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-961-4311
Mailing Address - Street 1:5 HEINZ TER
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15215-2511
Mailing Address - Country:US
Mailing Address - Phone:412-784-9403
Mailing Address - Fax:
Practice Address - Street 1:NAS CORPUS CHRISTI
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78419-5021
Practice Address - Country:US
Practice Address - Phone:361-961-4311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA-000061L261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care