Atascosa Health Center, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Lytle, TX
NPI 1003359209 · NPPES record last updated Feb 10, 2026
Key facts
- NPI
- 1003359209
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- ATASCOSA HEALTH CENTER, INC.
- Practice address
- 19010 Preist Blvd
Lytle, TX 78052-3486 - Phone
- (830) 772-9865
- Fax
- (830) 772-9821
- NPI assigned
- Nov 21, 2016
- Organization subpart
- Yes
- Parent organization (as reported)
- ATASCOSA HEALTH CENTER, INC.
Authorized official
- Name
- Monty Small, CMPE
- Title
- Chief Executive Officer
- Phone
- (830) 569-8940
Parent organization (reported in NPPES) 1
Other NPIs on the same Medicare enrollment 7
Other NPIs with the same Medicare PAC ID 7
Corporate family (same tax ID) 7
Practitioners 22
-
Ashwin Sam Koshy, DO
-
Michelle Allore, NP
-
Lynn Lea Bullard, FNP-BC
-
Laura L Crafton, M.D.
-
Rachel R Dockery, MD
-
Dora L. Gonzalez, M.D.
-
Angela R Karsky, P.A.
-
Susan Kay McCarty, LPC
-
Rayford Benard Mitchell, M.D.
-
Fnu Rajlakshmi, M.D.
-
Meredyth Richter, N.P.-C
-
Brandy Ree Schjang, APRN, FNP-C
-
Yomara Tietze, FNP
-
Paul Turner, FNP
-
Karah Wiatrek, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX
Federally qualified health center certification: CCN 741947
- Legal name
- ATASCOSA HEALTH CENTER, INC.
- Doing business as
- LYTLE COMMUNITY HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Mar 6, 2017
- Last certification
- Mar 6, 2017
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Dec 7, 1979 in TX
- Enrollment address
- 19010 Preist Blvd
Lytle, TX 78052-3486
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Virginia Herring |
Corporate Officer |
Jul 27, 2017 | |
| Lillian R Cashmer |
Corporate Officer |
Oct 3, 2008 | |
| Kara Luna |
Corporate Director |
Sep 28, 2017 | |
| Carlos Vidal Munoz |
Corporate Director |
Sep 28, 2017 | |
| Monty B Small |
Corporate Officer |
Sep 1, 2004 | |
| W-2 Managing Employee |
Sep 1, 2004 | ||
| Other |
Sep 1, 2004 | ||
| Lillian W Lyssey |
Corporate Officer |
Oct 1, 2008 | |
| James Teal |
Corporate Officer |
Apr 28, 2016 | |
| Dwayne Villanueva |
Corporate Officer |
Jan 5, 2010 | |
| Tammy H Favor |
Corporate Officer |
Mar 28, 2013 | |
| Henry Salas |
Corporate Director |
Sep 28, 2017 | |
| Maria Garcia |
Corporate Officer |
Feb 1, 2005 | |
| W-2 Managing Employee |
Feb 1, 2005 | ||
| Rosario C Oropeza |
Corporate Director |
May 13, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040420001663 | TX | Part B Supplier - Clinic/Group Practice | 3779579412 |
Receives reassigned benefits from 25 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Poteet, TX; Three Rivers, TX; Tilden, TX; Lytle, TX; Karnes City, TX; Floresville, TX; Pleasanton, TX |
| O20170310000336 | TX | Part a Provider - Federally Qualified Health Center (FQHC) | 3779579412 | Practice locations: Lytle, TX |
National Provider Directory
- Tax ID family
- Atascosa Health Center
- Part of
- Atascosa Health Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
19010 Preist Blvd
Lytle, TX 78052-3486
Mailing address
310 W Oaklawn Rd
Pleasanton, TX 78064-4033
Phone (830) 569-8940
Other providers in Lytle, TX
- Alvarado First Assisting LLC
- Gabriel Alvarado
- Elena Misa Angus
- Antoun Y Antoun
- Daniel F. Ascencao
- Linda Louise Atwood
- Carolyn J Barnette
- Patricia Barrera
- Esther G. Basaldua
- Maribel Benavides
All providers in Lytle, TX · Federally Qualified Health Center (FQHC) in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.