=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124796081
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DRISCOLL CHILDRENS HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/03/2021
-----------------------------------------------------
Last Update Date | 12/10/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2820 MICHAELANGELO DR
-----------------------------------------------------
City | EDINBURG
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78539-1402
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 361-694-5000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3533 S ALAMEDA ST
-----------------------------------------------------
City | CORPUS CHRISTI
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78411-1721
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 361-694-5000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF FINANCIAL OFFICER
-----------------------------------------------------
Name | STEVEN KING
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 361-694-5000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA1903X
-----------------------------------------------------
Taxonomy Name | Ambulatory Surgical Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 282NC2000X
-----------------------------------------------------
Taxonomy Name | Children's Hospital
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------