Provider Demographics
NPI:1831238773
Name:CORPUS CHRISTI ENDOSCOPY CENTER LLP
Entity type:Organization
Organization Name:CORPUS CHRISTI ENDOSCOPY CENTER LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:361-737-0880
Mailing Address - Street 1:6421 SARATOGA BLVD BLDG 105
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-3480
Mailing Address - Country:US
Mailing Address - Phone:361-737-0880
Mailing Address - Fax:361-985-9301
Practice Address - Street 1:6421 SARATOGA BLVD
Practice Address - Street 2:BLDG 105
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-3479
Practice Address - Country:US
Practice Address - Phone:361-985-9300
Practice Address - Fax:361-985-9301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical