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Organization Active NPI

Gonzales Healthcare Systems

Doing business as Sievers Medical Clinic

  • Rural Health Clinic/Center
  • Gonzales, TX
National Provider Identifier
1013916287
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GONZALES HEALTHCARE SYSTEMS
Doing business as
Sievers Medical Clinic
Practice address
1110 N Sarah Dewitt Dr
Gonzales, TX 78629-3311
Phone
(830) 672-7581
Fax
(830) 672-2401
NPI assigned
Jul 19, 2005
Last updated
Jul 23, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
GONZALES HEALTHCARE SYSTEMSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Authorized official

Name
Mr. Brandon Anzaldua
Title
Ceo Administrator
Phone
(830) 672-7581

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 000130 TX
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 000103 TX
Rural Health Clinic/Center 261QR1300X TX Primary

Addresses

Primary practice location

1110 N Sarah Dewitt Dr
Gonzales, TX 78629-3311

Mailing address

PO Box 587
Gonzales, TX 78629-0587
Phone (830) 672-7581

Other practice location 1

1300 Captain Albert Martin Trail
Gonzales, TX 78629
Phone (830) 672-8502

Other practice location 2

207 West 7th Street
Shiner, TX 77984
Phone (361) 239-5015

Other practice location 3

1605 N Sarah DeWitt Dr
Gonzales, TX 78629-2700
Phone (830) 672-7581

Other names 1

  • Sievers Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040316001074 TX Part B Supplier - Clinic/Group Practice 8527963776 Receives reassigned benefits from 56 practitioners
3 other NPIs on this enrollment
Practice locations: Shiner, TX; Gonzales, TX
O20041001000394 TX Part A Provider - Rural Health Clinic 8527963776 Practice locations: Gonzales, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013916287. Details of each certification follow.

Rural health clinic certification: CCN 453456

Legal name
GONZALES HEALTHCARE SYSTEMS
Doing business as
SIEVERS MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 10, 1993
Last certification
Jun 21, 2022
Ownership / control type
Non-profit – church related
Organization structure
OtherProprietary
Incorporated
Aug 10, 1993 in TX
Enrollment address
1110 N Sarah Dewitt Dr
Gonzales, TX 78629-3311
Related CCNs
450235

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

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Memorial Hospital

Locations

1110 N Sarah Dewitt Dr
Ste 78629
Gonzales, TX 78629

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
Brandon Anzaldua Individual Corporate OfficerCeo Aug 1, 2023
Wayne South Individual Corporate DirectorDirector Jun 4, 2019
Gregory Charles Tieken Individual Corporate DirectorBoard of Directors May 7, 2016
Timothy Markham Individual Corporate Director Oct 1, 2004
William V Bailey Individual Corporate OfficerCfo Jul 5, 2023
Kenneth Gottwald Individual Corporate DirectorBoard of Directors May 12, 2012
Gene Reed Individual Corporate Director Jun 8, 2010
Kerry Frank Morgan Individual Corporate Director Sep 3, 2013
Stephanie L Kodack Individual Corporate Officer Jun 29, 2017
Juli Clay Individual Corporate OfficerCompliance Officer Dec 1, 2001
W-2 Managing Employee Dec 1, 2001
Gonzales Healthcare Systems Organization, Gonzales, TX Operational/Managerial Control Jul 15, 2010
Lisa Gindler Individual Corporate Director Oct 1, 2004
Sascha Kardosz Individual Corporate DirectorDirector May 5, 2018

Owners & managing parties with NPI records 7

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

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Memorial HospitalGonzales, TX, CCN 450235 Hospital Operational/Managerial Control Jul 15, 2010
The Heights of GonzalesGonzales, TX, CCN 676138 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 31, 2013
Avir at GonzalesGonzales, TX, CCN 675124 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2025
Avir at MagnoliaLuling, TX, CCN 676044 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2015
Memorial Hospital Home Health AgencyGonzales, TX, CCN 457634 Home health agency Other (100%) Jun 1, 1984
Sievers Medical Clinic - WaelderWaelder, TX, CCN 453481 Rural health clinic Operational/Managerial Control (100%) Jul 15, 2010
Sievers Medical Clinic - ShinerShiner, TX, CCN 673488 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2020

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 6

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

Practitioners & affiliated clinicians

Practitioners 58

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 58

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753228800000",
    "number": "1013916287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 587",
            "city": "GONZALES",
            "state": "TX",
            "postal_code": "786290587",
            "telephone_number": "830-672-7581",
            "fax_number": "830-672-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 N SARAH DEWITT DR",
            "city": "GONZALES",
            "state": "TX",
            "postal_code": "786293311",
            "telephone_number": "830-672-7581",
            "fax_number": "830-672-2401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Captain Albert Martin Trail",
            "address_purpose": "LOCATION",
            "city": "Gonzales",
            "state": "TX",
            "postal_code": "78629",
            "country_code": "US",
            "telephone_number": "830-672-8502",
            "fax_number": "830-672-3035",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "207 West 7th Street",
            "address_purpose": "LOCATION",
            "city": "Shiner",
            "state": "TX",
            "postal_code": "77984",
            "country_code": "US",
            "telephone_number": "361-239-5015",
            "fax_number": "361-672-3035",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1605 N Sarah DeWitt Dr",
            "address_purpose": "LOCATION",
            "city": "Gonzales",
            "state": "TX",
            "postal_code": "786292700",
            "country_code": "US",
            "telephone_number": "830-672-7581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GONZALES HEALTHCARE SYSTEMS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GONZALES HEALTHCARE SYSTEMS",
        "enumeration_date": "2005-07-19",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A",
        "authorized_official_last_name": "ANZALDUA",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "CEO ADMINISTRATOR",
        "authorized_official_telephone_number": "830-672-7581",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "000130",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "000103",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sievers Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sievers Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gonzales, TX

Sources for this page

Verify at the official NPI Registry.