Provider Demographics
NPI:1922410554
Name:NAVAL HEALTH CLINIC CORPUS CHRISTI
Entity Type:Organization
Organization Name:NAVAL HEALTH CLINIC CORPUS CHRISTI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF DHA POSC
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-536-6650
Mailing Address - Street 1:NAVAL HEALTH CLINIC CORPUS CHRISTI
Mailing Address - Street 2:10651 E ST STE 2031
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78419-5130
Mailing Address - Country:US
Mailing Address - Phone:817-782-5906
Mailing Address - Fax:817-782-5908
Practice Address - Street 1:1711 DOOLITTLE AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76127
Practice Address - Country:US
Practice Address - Phone:817-782-5906
Practice Address - Fax:817-782-5908
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAVAL HEALTH CLINIC CORPUS CHRISTI
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-02
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2146013OtherPK