Provider Demographics
NPI:1669627428
Name:SARATOGA MEDICAL CENTER
Entity type:Organization
Organization Name:SARATOGA MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JO
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-852-0852
Mailing Address - Street 1:3434 SARATOGA BLVD
Mailing Address - Street 2:STE 103
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78415-5822
Mailing Address - Country:US
Mailing Address - Phone:361-232-5710
Mailing Address - Fax:361-232-5713
Practice Address - Street 1:3434 SARATOGA BLVD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78415-5822
Practice Address - Country:US
Practice Address - Phone:361-852-0852
Practice Address - Fax:361-852-0256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE2071261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0835969-01Medicaid
TX0835969-01Medicaid