Provider Demographics
NPI:1215064506
Name:DRISCOLL CHILDREN'S HOSPITAL
Entity type:Organization
Organization Name:DRISCOLL CHILDREN'S HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-694-6126
Mailing Address - Street 1:PO BOX 926
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78294-0926
Mailing Address - Country:US
Mailing Address - Phone:361-694-5000
Mailing Address - Fax:361-694-4659
Practice Address - Street 1:3533 S ALAMEDA ST
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:361-694-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX178036341600000X
344800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No344800000XTransportation ServicesAir Carrier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX132812202Medicaid
TX132812210Medicaid