Healthcare Provider Details

I. General information

NPI: 1013142553
Provider Name (Legal Business Name): CBSH,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2009
Last Update Date: 03/19/2022
Certification Date: 03/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6130 PARKWAY DR.
CORPUS CHRISTI TX
78414-2455
US

IV. Provider business mailing address

6130 PARKWAY DR.
CORPUS CHRISTI TX
78414-2455
US

V. Phone/Fax

Practice location:
  • Phone: 361-993-2000
  • Fax: 361-985-6834
Mailing address:
  • Phone: 361-993-2000
  • Fax: 361-985-6834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER BOYD BALDOCK
Title or Position: OFFICER AND AUTHORIZED OFFICIAL
Credential:
Phone: 615-234-5935