Provider Demographics
NPI:1730157884
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:CFO
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-881-3225
Mailing Address - Street 1:600 ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2235
Mailing Address - Country:US
Mailing Address - Phone:361-881-3225
Mailing Address - Fax:361-884-7276
Practice Address - Street 1:1038 TEXAS YES BLVD
Practice Address - Street 2:
Practice Address - City:ROBSTOWN
Practice Address - State:TX
Practice Address - Zip Code:78380-6142
Practice Address - Country:US
Practice Address - Phone:361-881-3225
Practice Address - Fax:361-884-7276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX017889901Medicaid
TX063532801Medicaid
TX458612Medicare ID - Type UnspecifiedRURAL HEALTH CLINIC