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General NPI Number Information
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NPI Number | 1003845108
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Entity Type | Organization
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Legal Business Name | CITY OF CORPUS CHRISTI
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 12/20/2011
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Provider Practice Location Address
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Address Line | 1702 HORNERD
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City | CORPUS CHRISTI
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State | TX
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Zip | 78416
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Country | US
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Telephone | 361-826-1303
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Fax | 361-826-7212
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Provider Business Mailing Address
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Address Line | 1201 LEOPARD
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City | CORPUS CHRISTI
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State | TX
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Zip | 78401
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Country | US
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Telephone | 361-826-1303
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Fax | 361-826-7212
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Authorized Official
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Title or Position | DIVISION DIRECTOR
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Name | MS. SANDRA S HEATHERLEY
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Credential | M.P.H. MT(ASCP)
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Telephone | 361-851-7214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 45D0660522
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | C13938
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | C13938
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | C13938
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License Number State | TX
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