Provider Demographics
NPI:1528848538
Name:CHRISTUS SPOHN HEALTH SYSTEM CORPORATION
Entity type:Organization
Organization Name:CHRISTUS SPOHN HEALTH SYSTEM CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMINGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-881-3988
Mailing Address - Street 1:1521 S STAPLES ST
Mailing Address - Street 2:STE 102
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-3159
Mailing Address - Country:US
Mailing Address - Phone:361-888-7779
Mailing Address - Fax:361-888-7791
Practice Address - Street 1:1521 S STAPLES ST
Practice Address - Street 2:STE 102
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-3159
Practice Address - Country:US
Practice Address - Phone:361-888-7779
Practice Address - Fax:361-888-7791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-05
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical