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1598749707

NPI Code Detail

MEDICARE: CHRISTUS HEALTH SOUTHEAST TEXAS

MEDICARE: CHRISTUS HEALTH SOUTHEAST TEXAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center
2	282NR1301X	Rural Acute Care Hospital	000038	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	75270390475951	OTHER	TX	CHAMPVA
2	HH0633	OTHER	TX	BLUE CROSS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	450573	OTHER	TX	UNICARE
5	8059	OTHER	TX	UTMB CHIPS
6	0921543	OTHER	TX	CIGNA
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	759510003	OTHER	TX	USFHP
10	0873414	OTHER	TX	AETNA

General Provider Information

NPI Number	:	1598749707
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTUS HEALTH SOUTHEAST TEXAS

Provider Business Mailing Address
First Line	:	PO BOX 848060
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-8060
Country	:	US
Telephone Number	:	800-756-7999
Fax Number	:	469-282-1999

Provider Business Practice Location Address
First Line	:	1275 MARVIN HANCOCK DR
Second Line	:
City	:	JASPER
State	:	TX
Zip	:	75951-4935
Country	:	US
Telephone Number	:	409-384-5461
Fax Number	:	409-384-1900

Authorized Official
Title or Position	:	PRESIDENT / CEO
Name	:	PAUL TREVINO
Credential	:
Telephone Number	:	409-899-7102

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	10/19/2022

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Directions to “CHRISTUS HEALTH SOUTHEAST TEXAS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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