Provider Demographics
NPI:1124482013
Name:CHRISTUS HEALTH SOUTHEAST TEXAS
Entity type:Organization
Organization Name:CHRISTUS HEALTH SOUTHEAST TEXAS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:TREVINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-899-7102
Mailing Address - Street 1:PO BOX 848060
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-8060
Mailing Address - Country:US
Mailing Address - Phone:800-756-7999
Mailing Address - Fax:
Practice Address - Street 1:494 SPRINGHILL ST
Practice Address - Street 2:SUITE 200
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951-4922
Practice Address - Country:US
Practice Address - Phone:409-381-5750
Practice Address - Fax:409-384-2018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-07
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health