Provider Demographics
NPI:1902508286
Name:SOUTH TEXAS HOSPITALIST PLLC
Entity Type:Organization
Organization Name:SOUTH TEXAS HOSPITALIST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CORINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:OLMEDA
Authorized Official - Suffix:
Authorized Official - Credentials:AAS, NCRT
Authorized Official - Phone:361-299-0125
Mailing Address - Street 1:2201 CLEO ST STE B
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78405-1914
Mailing Address - Country:US
Mailing Address - Phone:361-299-0125
Mailing Address - Fax:361-299-7763
Practice Address - Street 1:2201 CLEO ST STE B
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-1914
Practice Address - Country:US
Practice Address - Phone:361-299-0125
Practice Address - Fax:361-299-7763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty