Provider Demographics
NPI:1669954194
Name:SOUTHCROSS HOSPITAL LLC
Entity type:Organization
Organization Name:SOUTHCROSS HOSPITAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-305-1017
Mailing Address - Street 1:PO BOX 1016
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78294-1016
Mailing Address - Country:US
Mailing Address - Phone:210-373-8570
Mailing Address - Fax:888-604-9219
Practice Address - Street 1:4243 E SOUTHCROSS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78222-3727
Practice Address - Country:US
Practice Address - Phone:210-373-8570
Practice Address - Fax:888-604-9219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-31
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital