Provider Demographics
NPI:1487902870
Name:CORPUS CHRISTI BIRTH CENTER PLLC
Entity type:Organization
Organization Name:CORPUS CHRISTI BIRTH CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:OVERTON
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:361-883-2229
Mailing Address - Street 1:939 AYERS ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-1915
Mailing Address - Country:US
Mailing Address - Phone:361-883-2229
Mailing Address - Fax:361-336-0212
Practice Address - Street 1:939 AYERS ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-1915
Practice Address - Country:US
Practice Address - Phone:361-883-2229
Practice Address - Fax:361-336-0212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-16
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX150023261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing