# CHRISTUS HEALTH SOUTHEAST TEXAS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CHRISTUS Southeast Texas - Jasper Memorial
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598749707
- **Authorized official:** PAUL TREVINO (PRESIDENT / CEO)
- **Authorized official phone:** (409) 899-7102

## Contact information

- **Practice address:** 1275 MARVIN HANCOCK DR, JASPER, TX 75951-4935
- **Practice address phone:** (409) 384-5461
- **Practice address fax:** (409) 384-1900
- **Mailing address:** PO BOX 848060, DALLAS, TX 75284-8060
- **Mailing address phone:** (800) 756-7999
- **Mailing address fax:** (469) 282-1999

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | — |
| 282NR1301X | Rural Acute Care Hospital | 000038 | TX | Yes |

## Other

- **Enumeration date:** 12/01/2005
- **Last updated:** 10/19/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0873414 | AETNA | TX |
| 01 | — | 0921543 | CIGNA | TX |
| 05 | — | 112706001 | — | TX |
| 05 | — | 112706002 | — | TX |
| 05 | — | 112706003 | — | TX |
| 01 | — | 450573 | UNICARE | TX |
| 01 | — | 75270390475951 | CHAMPVA | TX |
| 01 | — | 759510003 | USFHP | TX |
| 01 | — | 8059 | UTMB CHIPS | TX |
| 01 | — | HH0633 | BLUE CROSS | TX |