Provider Demographics
NPI:1912311028
Name:UTC PROVIDERS - CORPUS CHRISTI INC
Entity type:Organization
Organization Name:UTC PROVIDERS - CORPUS CHRISTI INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR, RCM DIVISION
Authorized Official - Prefix:
Authorized Official - First Name:NATHALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACKSTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-323-6900
Mailing Address - Street 1:1521 S STAPLES ST
Mailing Address - Street 2:SUITE 803
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-3150
Mailing Address - Country:US
Mailing Address - Phone:361-882-9675
Mailing Address - Fax:512-375-3865
Practice Address - Street 1:1521 S STAPLES ST
Practice Address - Street 2:SUITE 803
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-3150
Practice Address - Country:US
Practice Address - Phone:361-882-9675
Practice Address - Fax:512-375-3865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-17
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty