Provider Demographics
NPI:1821009242
Name:ADVENTIST HEALTH SYSTEM/SUNBELT, INC.
Entity Type:Organization
Organization Name:ADVENTIST HEALTH SYSTEM/SUNBELT, INC.
Other - Org Name:CENTRAL TEXAS MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-753-3505
Mailing Address - Street 1:PO BOX 6427
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76115-0427
Mailing Address - Country:US
Mailing Address - Phone:512-753-3505
Mailing Address - Fax:512-753-8979
Practice Address - Street 1:1301 WONDER WORLD DR
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7533
Practice Address - Country:US
Practice Address - Phone:512-753-3505
Practice Address - Fax:512-753-8979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000556261QA1903X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121789503OtherSUPERIOR HEALTH PLAN CHIP
TX121789503Medicaid
TX450272OtherAMERICAN PIONEER LIFE
TX616461OtherAETNA
TX14022OtherSCOTT & WHITE HEALTH PL
TX121789505OtherMEDICAID-CSHCN ACUTE
TX121789506OtherMEDCAID-CSHCN HASC
TX6542460OtherAETNA
TXHH5124OtherBCBS
TX450272OtherSTERLING
TX121789502OtherHASC - MEDICAID
TX450272OtherUNICARE PPO
TX450272OtherCONSECO
TX1217895-05OtherMEDICAID-CSHCN ACUTE
TXHH0460OtherBLUE CROSS BLUE SHIELD
TX102778100OtherFIRST HEALTH
TX450272OtherWORKER COMPENSATION
TX1217895-05OtherMEDICAID-CSHCN ACUTE
TX=========OtherTRICARE/CHAMPUS/VA
TX=========OtherFIRSTHEALTH MAIL HANDLERS
TX450272Medicare Oscar/Certification