Provider Demographics
NPI:1871602789
Name:HIRSCH, CHRISTIAN J (MD PC)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:J
Last Name:HIRSCH
Suffix:
Gender:M
Credentials:MD PC
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13814 CAPTAIN KIDD DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-6381
Mailing Address - Country:US
Mailing Address - Phone:917-544-1369
Mailing Address - Fax:
Practice Address - Street 1:3302 S ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1821
Practice Address - Country:US
Practice Address - Phone:361-443-8825
Practice Address - Fax:800-655-2081
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY204067208C00000X
TXT5124208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6C1591OtherHEALTHNET ID#
NYP927644OtherOXFORD ID#
NY0192217OtherGHI PPO#
NY1733914OtherAETNA HMO
NY5989636OtherAETNA PPO#
NY01884335Medicaid
TX463151701Medicaid
NY2J6581OtherEMPIRE BCBS #
NY260874829OtherTAX IDENTIFICATION NUMBER
NYG68759Medicare UPIN