Provider Demographics
NPI:1215160874
Name:CHRISTUS HEALTH GULF COAST
Entity type:Organization
Organization Name:CHRISTUS HEALTH GULF COAST
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGIONAL PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:B
Authorized Official - Last Name:CARRIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-391-3031
Mailing Address - Street 1:18300 SAINT JOHN DR
Mailing Address - Street 2:
Mailing Address - City:NASSAU BAY
Mailing Address - State:TX
Mailing Address - Zip Code:77058-6302
Mailing Address - Country:US
Mailing Address - Phone:281-333-5503
Mailing Address - Fax:281-333-8891
Practice Address - Street 1:2020 NASA PKWY
Practice Address - Street 2:SUITE 180
Practice Address - City:NASSAU BAY
Practice Address - State:TX
Practice Address - Zip Code:77058-3683
Practice Address - Country:US
Practice Address - Phone:281-523-3355
Practice Address - Fax:281-523-3336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-31
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0A5004Medicare PIN