CHRISTUS Southeast Texas - Family Practice Center Kirbyville – Rural Health Clinic/Center, NPI 1063485548
Rural Health Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for CHRISTUS Southeast Texas - Family Practice Center Kirbyville
205, East Lavielle Street, Kirbyville, Jasper County, Texas, 75956, United States
KIRBYVILLE, TX 759562119
Phone: (409) 423-2217
Fax: (409) 423-2421
Type: Location
PO BOX 848060
DALLAS, TX 752848060
Phone: (800) 756-7999
Fax: (469) 282-1999
Type: Mailing
CHRISTUS Southeast Texas - Jasper Memorial, 1275, Marvin Hancock Drive, Jasper, Jasper County, Texas, 75951, United States
JASPER, TX 759514935
Phone: (409) 384-1872
Fax: (409) 383-0622
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-07-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-09-30 (982 days ago).
Enrollment records
1
Earliest due date
2023-09-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040707000434 | O | Rural Health Clinic | TX | 2023-09-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 75956)
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