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General NPI Number Information
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NPI Number | 1598749707
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Entity Type | Organization
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Legal Business Name | CHRISTUS HEALTH SOUTHEAST TEXAS
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Dates
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Enumeration Date | 12/01/2005
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 1275 MARVIN HANCOCK DR
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City | JASPER
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State | TX
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Zip | 75951-4935
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Country | US
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Telephone | 409-384-5461
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Fax | 409-384-1900
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Provider Business Mailing Address
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Address Line | PO BOX 848060
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City | DALLAS
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State | TX
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Zip | 75284-8060
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Country | US
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Telephone | 800-756-7999
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Fax | 469-282-1999
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | PAUL TREVINO
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Credential |
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Telephone | 409-899-7102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | 000038
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License Number State | TX
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