Basic Information
| Provider Information | |||||||||
| NPI: | 1447228747 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CHRISTUS SPOHN HEALTH SYSTEM CORPORATION | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | CHRISTUS SPOHN HOSPITAL BEEVILLE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 847899 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752847899 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8007567999 | ||||||||
| FaxNumber: | 4692821999 | ||||||||
| Practice Location | |||||||||
| Address1: | 1500 E HOUSTON ST | ||||||||
| Address2: | |||||||||
| City: | BEEVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781025312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3613542000 | ||||||||
| FaxNumber: | 3613589322 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2006 | ||||||||
| LastUpdateDate: | 05/17/2022 | ||||||||
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| AuthorizedOfficialLastName: | BLOW | ||||||||
| AuthorizedOfficialFirstName: | OSBERT | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 3612882222 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 000429 | TX | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 1708704 | 05 | LA | MEDICAID | 022485901 | 05 | TX | MEDICAID | HH0566 | 01 | TX | BLUE CROSS | OTHER | 100100980A | 05 | KS | MEDICAID | 100470810A | 05 | IN | MEDICAID | 450082 | 01 | TX | UNITED HEALTH PLAN | OTHER | 020811801 | 05 | TX | MEDICAID | 200259320A | 05 | IN | MEDICAID | 45000082 | 05 | NC | MEDICAID | B1613 | 05 | NM | MEDICAID |