Provider Demographics
NPI:1588970305
Name:CORPUS CHRISTI WOMENS CARE CENTER, INC
Entity type:Organization
Organization Name:CORPUS CHRISTI WOMENS CARE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOZARTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-548-6718
Mailing Address - Street 1:2236 WHISPERING OAK DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-9225
Mailing Address - Country:US
Mailing Address - Phone:361-548-6718
Mailing Address - Fax:361-980-1344
Practice Address - Street 1:5920 SARATOGA BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4103
Practice Address - Country:US
Practice Address - Phone:361-548-6718
Practice Address - Fax:361-980-1344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-31
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2203207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG40701Medicare UPIN