Provider Demographics
NPI:1295890093
Name:ORTHOPEDIC & SPINE SURGICAL HOSPITAL OF SOUTH TEXAS, L.P.
Entity type:Organization
Organization Name:ORTHOPEDIC & SPINE SURGICAL HOSPITAL OF SOUTH TEXAS, L.P.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICER AND AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:BOYD
Authorized Official - Last Name:BALDOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-234-5954
Mailing Address - Street 1:18600 HARDY OAK BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4206
Mailing Address - Country:US
Mailing Address - Phone:210-507-4179
Mailing Address - Fax:210-404-0800
Practice Address - Street 1:18600 NORTH HARDY OAK BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4206
Practice Address - Country:US
Practice Address - Phone:210-404-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007868282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX158914501Medicaid
TX158914502Medicaid
TX349118800OtherDEPARTMENT OF LABOR ACL D
TXHH1019OtherBCBS
TXHH1019OtherBCBS