Provider Demographics
NPI:1740044155
Name:SOUTH TX MISSION OF MERCY
Entity type:Organization
Organization Name:SOUTH TX MISSION OF MERCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTPR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:AOSHIMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-500-0122
Mailing Address - Street 1:1660 S STAPLES ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-3173
Mailing Address - Country:US
Mailing Address - Phone:301-325-6388
Mailing Address - Fax:361-298-2191
Practice Address - Street 1:1660 S STAPLES ST STE 100
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-3173
Practice Address - Country:US
Practice Address - Phone:301-325-6388
Practice Address - Fax:361-298-2191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty