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Organization
SANTA ROSA FAMILY HEALTH CENTER
Active
Organization
SANTA ROSA FAMILY HEALTH CENTER
Active
Other names
Santa Rosa Family Practice Residency Program
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTINE D CRISCUOLOHIGGINS MD (PROGRAM DIRECTOR)
(210) 703-9045
Entity
Organization
Contact information
Practice address
11130 CHRISTUS HLS, 3RD FLOOR, SAN ANTONIO, TX 78251-3585
(210) 703-9001
(210) 703-9155
Mailing address
11130 CHRISTUS HLS, MEDICAL PLAZA 3, 3RD FL, SAN ANTONIO, TX 78251-3585
(210) 703-9001
(210) 703-9155
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0803595-01
—
TX
01
—
0803595-02
CIDC GROUP NUMBER
TX
01
—
0803595-03
EPSDT FACILITY NUMBER
TX
Enumeration date
07/19/2005
Last updated
07/21/2022
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