MEDICARE: OBSTETRICAL & GYNECOLOGICAL ASSOCIATES OF CORPUS CHRISTI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578564043
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OBSTETRICAL & GYNECOLOGICAL ASSOCIATES OF CORPUS CHRISTI

Provider Business Mailing Address
First Line	:	5920 SARATOGA BLVD
Second Line	:	STE 200
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-4103
Country	:	US
Telephone Number	:	361-994-5454
Fax Number	:	361-994-5455

Provider Business Practice Location Address
First Line	:	5920 SARATOGA BLVD
Second Line	:	STE 200
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-4103
Country	:	US
Telephone Number	:	361-994-5454
Fax Number	:	361-994-5455

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. JANA RYE
Credential	:
Telephone Number	:	361-994-5454

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	03/02/2022

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Directions to “OBSTETRICAL & GYNECOLOGICAL ASSOCIATES OF CORPUS CHRISTI ” Practice Location

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