Healthcare Provider Details
I. General information
NPI: 1447883301
Provider Name (Legal Business Name): CHRISTUS SANTA ROSA HEALTH CARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/19/2020
Last Update Date: 05/06/2022
Certification Date: 05/06/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1301 WONDER WORLD DR
SAN MARCOS TX
78666-7533
US
IV. Provider business mailing address
PO BOX 846131
DALLAS TX
75284-6131
US
V. Phone/Fax
- Phone: 512-353-8979
- Fax: 512-753-3598
- Phone: 800-756-7999
- Fax: 469-282-1791
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHANIE
PARKER
Title or Position: CEO
Credential:
Phone: 210-704-3657