Healthcare Provider Details

I. General information

NPI: 1154317774
Provider Name (Legal Business Name): ST JOSEPH REGIONAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 07/12/2022
Certification Date: 07/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 S JUDSON ST
NAVASOTA TX
77868-3704
US

IV. Provider business mailing address

210 S JUDSON ST
NAVASOTA TX
77868-3704
US

V. Phone/Fax

Practice location:
  • Phone: 936-825-6585
  • Fax: 936-870-4582
Mailing address:
  • Phone: 936-825-6585
  • Fax: 936-870-4582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: RICARDO DIAZ
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 979-776-2580