NPIMap

Organization Active NPI

Christus Spohn Health System Corporation

Doing business as CHRISTUS Spohn Family Health Center Freer

  • Rural Health Clinic/Center
  • Freer, TX
National Provider Identifier
1043289804
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CHRISTUS SPOHN HEALTH SYSTEM CORPORATION
Doing business as
CHRISTUS Spohn Family Health Center Freer
Practice address
111 E Riley St
Freer, TX 78357-1830
Phone
(361) 394-7311
Fax
(361) 394-7158
NPI assigned
Mar 15, 2006
Last updated
Feb 4, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dominic Dominguez
Title
Ceo
Phone
(210) 881-3988

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 204C00000X
Clinic/Center 261Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

111 E Riley St
Freer, TX 78357-1830

Mailing address

PO Box 847899
Dallas, TX 75284-7899
Phone (800) 756-7999

Other identifiers 3

IdentifierTypeStateIssuer
0096HZOtherTXBLUE CROSS
173157202MedicaidTX
173157201MedicaidTX

Other names 1

  • CHRISTUS Spohn Family Health Center Freer Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040630000696 TX Part A Provider - Rural Health Clinic 8426967894 Practice locations: Freer, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043289804. Details of each certification follow.

Rural health clinic certification: CCN 458855

Legal name
CHRISTUS SPOHN HEALTH SYSTEM CORPORATION
Doing business as
CHRISTUS SPOHN FAMILY HEALTH CENTER FREER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 29, 2004
Last certification
Dec 8, 2015
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Aug 10, 1965 in TX
Enrollment address
111 E Riley St
Freer, TX 78357-1830
Related CCNs
450828

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1103423Christus Spohn Family Health Center-Freer111 East Riley Street, Freer, TX 78357Certificate of waiverAug 10, 2027

National Provider Directory

National Provider Directory
Tax ID family
Spohn Hospital Renal Care5 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

111 E Riley St
Freer, TX 78357
Phone (361) 394-7311

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jeffrey Puckett Individual Corporate DirectorBoard Member Jan 1, 2024
Christus Health Organization, Irving, TX Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Jul 1, 2004 100%
Rebecca B Rios Individual Corporate OfficerCfo Nov 19, 2019
W-2 Managing EmployeeCfo Nov 19, 2019
Bill Colston Individual Corporate DirectorBoard Member Apr 1, 2024
Nueces County Hospital District Organization, Corpus Christi, TX Other Oct 1, 2012
Gabriel Guerra Individual Corporate DirectorBoard Member Jan 1, 2019
Mary C Henry Individual Corporate DirectorBoard Member Jan 1, 2024
Dominic Dominguez Individual Corporate OfficerCeo Jan 1, 2023
Corporate DirectorCeo Jan 1, 2023
Orel M Everett Individual Corporate DirectorBoard Member Jan 1, 2024
Kirkby E Townsend Individual Corporate DirectorBoard Member Jan 1, 2018
Audrey Webber Individual Corporate DirectorBoard Member Jun 4, 2024
Yvonne H Hinojosa Individual Corporate DirectorBoard Member Jan 1, 2024
Shah Faizul Islam Individual Corporate DirectorBoard Member Jan 1, 2022

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 47

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 47

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770163200000",
    "number": "1043289804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847899",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847899",
            "telephone_number": "800-756-7999",
            "fax_number": "469-282-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E RILEY ST",
            "city": "FREER",
            "state": "TX",
            "postal_code": "783571830",
            "telephone_number": "361-394-7311",
            "fax_number": "361-394-7158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTUS SPOHN HEALTH SYSTEM CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A",
        "authorized_official_last_name": "DOMINGUEZ",
        "authorized_official_first_name": "DOMINIC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "210-881-3988"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0096HZ",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173157202",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173157201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHRISTUS Spohn Family Health Center Freer",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHRISTUS Spohn Family Health Center Freer",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Freer, TX

Sources for this page

Verify at the official NPI Registry.