Provider Demographics
NPI:1669795084
Name:CORPUS CHRISTI PRIMARY CARE ASSOCIATES, PLLC
Entity type:Organization
Organization Name:CORPUS CHRISTI PRIMARY CARE ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-852-1550
Mailing Address - Street 1:3301 S ALAMEDA ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1882
Mailing Address - Country:US
Mailing Address - Phone:361-857-2900
Mailing Address - Fax:361-857-8321
Practice Address - Street 1:3301 S ALAMEDA ST
Practice Address - Street 2:SUITE 201
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1882
Practice Address - Country:US
Practice Address - Phone:361-857-2900
Practice Address - Fax:361-857-8321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-12
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty