Organization
CHRISTUS HEALTH SOUTHEAST TEXAS
Active
Other names
CHRISTUS Southeast Texas - Jasper Memorial
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL TREVINO (PRESIDENT / CEO)
(409) 899-7102
Entity
Organization
Contact information
Practice address
1275 MARVIN HANCOCK DR, JASPER, TX 75951-4935
(409) 384-5461
(409) 384-1900
Mailing address
PO BOX 848060, DALLAS, TX 75284-8060
(800) 756-7999
(469) 282-1999
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
282NR1301X
Rural Acute Care Hospital
Primary
000038
TX
Other
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
Enumeration date
12/01/2005
Last updated
10/19/2022
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