Provider Demographics
NPI:1194787218
Name:CHRISTUS SANTA ROSA HEALTH CARE CORPORATION
Entity type:Organization
Organization Name:CHRISTUS SANTA ROSA HEALTH CARE CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-704-3657
Mailing Address - Street 1:PO BOX 846131
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-6131
Mailing Address - Country:US
Mailing Address - Phone:800-756-7999
Mailing Address - Fax:469-282-1791
Practice Address - Street 1:2827 BABCOCK RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4813
Practice Address - Country:US
Practice Address - Phone:210-705-6190
Practice Address - Fax:210-705-6094
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHRISTUS SANTA ROSA HEALTH CARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-04
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA1903X
TX000339282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0003OtherTRICARE FOR LIFE RD
TX7885153OtherAETNA RN
TX175884200OtherUS DEPT. OF LABOR
TX6548210OtherAETNA RD
TXH04980OtherOXFORD HEALTH PLAN
TX1013OtherCOMMUNITY FIRST RN
TX1013RNOtherCOMMUNITY FIRST STAR RN
TXA7829101OtherJOHN DEERE
TX0000OtherTRICARE FOR LIFE RN
TX094486001Medicaid
TX909665OtherCONNECTICARE
TX1012OtherCOMMUNITY FIRST
TX020844901Medicaid
TX1012RDOtherCOMMUNITY FIRST STAR RD
TX6548210OtherAETNA RD
450237Medicare UPIN