Provider Demographics
NPI:1881663631
Name:CHRISTUS SPOHN HEALTH SYSTEM CORPORATION
Entity Type:Organization
Organization Name:CHRISTUS SPOHN HEALTH SYSTEM CORPORATION
Other - Org Name:CHRISTUS SPOHN MEDICAL CLINIC BEEVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-881-3225
Mailing Address - Street 1:600 ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2235
Mailing Address - Country:US
Mailing Address - Phone:361-881-3225
Mailing Address - Fax:361-884-7276
Practice Address - Street 1:1602 E. HOUSTON HIGHWAY
Practice Address - Street 2:
Practice Address - City:BEEVILLE
Practice Address - State:TX
Practice Address - Zip Code:78102-5324
Practice Address - Country:US
Practice Address - Phone:361-881-3225
Practice Address - Fax:361-884-7276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0063BYOtherBLUE CROSS
TX092949901OtherMEDICAID FAMILY PLANNING
TX092949902Medicaid
TX0063BYOtherBLUE CROSS