Provider Demographics
NPI:1548286172
Name:DRISCOLL CHILDRENS HOSPITAL
Entity type:Organization
Organization Name:DRISCOLL CHILDRENS HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-694-5146
Mailing Address - Street 1:P O BOX 926
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78294
Mailing Address - Country:US
Mailing Address - Phone:361-694-5111
Mailing Address - Fax:361-694-5050
Practice Address - Street 1:3533 SOUTH ALAMEDA STREET
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1721
Practice Address - Country:US
Practice Address - Phone:361-694-4833
Practice Address - Fax:361-694-5050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 101YP2500X, 104100000X, 1041C0700X, 1041S0200X, 106H00000X, 133V00000X, 133VN1004X, 224Z00000X, 225100000X, 225X00000X, 235Z00000X, 261QA1903X, 261QE0700X
TX000488282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, PediatricGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH0611OtherBLUE CROSS BLUE SHIELD
TX132812203Medicaid
TX108051702OtherRURAL HEALTH CLINIC
TX108051703OtherTEXAS HEALTH STEPS
TX132812204OtherCIDC DAY SURGERY
TX1328122Medicaid
TX132812206OtherCIDC
TX132812205Medicaid
TX132812206OtherCIDC