Provider Demographics
NPI:1679713580
Name:CGI HOSPITAL
Entity type:Organization
Organization Name:CGI HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-487-7812
Mailing Address - Street 1:10500 HERITAGE BLVD STE 265
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-3631
Mailing Address - Country:US
Mailing Address - Phone:210-587-3697
Mailing Address - Fax:210-587-3698
Practice Address - Street 1:10500 HERITAGE BLVD STE 265
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-3631
Practice Address - Country:US
Practice Address - Phone:210-587-3697
Practice Address - Fax:210-587-3698
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METHODIST HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8745125364282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital