Provider Demographics
| NPI: | 1205242088 |
|---|---|
| Name: | CITIZEN'S MEDICAL CENTER COUNTY OF VICTORIA |
| Entity type: | Organization |
| Organization Name: | CITIZEN'S MEDICAL CENTER COUNTY OF VICTORIA |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CFO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | DUANE |
| Authorized Official - Middle Name: | L |
| Authorized Official - Last Name: | WOODS |
| Authorized Official - Suffix: | JR |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 361-572-5112 |
| Mailing Address - Street 1: | 2701 HOSPITAL DRIVE |
| Mailing Address - Street 2: | |
| Mailing Address - City: | VICTORIA |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 77901 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 361-582-7921 |
| Mailing Address - Fax: | 304-536-5031 |
| Practice Address - Street 1: | 2701 HOSPITAL DR |
| Practice Address - Street 2: | |
| Practice Address - City: | VICTORIA |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 77901-5748 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 361-573-9181 |
| Practice Address - Fax: | 361-572-5126 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | Yes |
| Parent Organization LBN: | CITIZENS MEDICAL CENTER COUNTY OF VICTORIA |
| Parent Organization TIN: | <UNAVAIL> |
| Enumeration Date: | 2014-07-01 |
| Last Update Date: | 2024-06-12 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | Group - Multi-Specialty |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
| No | 207QB0002X | Allopathic & Osteopathic Physicians | Family Medicine | Obesity Medicine | Group - Multi-Specialty |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
| No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
| No | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | Group - Multi-Specialty |
| No | 207RI0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | Group - Multi-Specialty |
| No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
| No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
| No | 208800000X | Allopathic & Osteopathic Physicians | Urology | Group - Multi-Specialty | |
| No | 208G00000X | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Group - Multi-Specialty | |
| No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Multi-Specialty | |
| No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |
