Provider Demographics
NPI:1982839494
Name:CHRISTIAN J. HIRSCH MD PC
Entity Type:Organization
Organization Name:CHRISTIAN J. HIRSCH MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HIRSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-544-1369
Mailing Address - Street 1:13814 CAPTAIN KIDD DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-6381
Mailing Address - Country:US
Mailing Address - Phone:917-544-1369
Mailing Address - Fax:
Practice Address - Street 1:7121 S PADRE ISLAND DR STE 112
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-4939
Practice Address - Country:US
Practice Address - Phone:361-299-0250
Practice Address - Fax:361-299-0255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-28
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204067208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX463151701Medicaid