NPIMap

Organization Active NPI

North Central Texas Community Health Care Center Inc

  • Federally Qualified Health Center (FQHC)
  • Wichita Falls, TX
National Provider Identifier
1083045454
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NORTH CENTRAL TEXAS COMMUNITY HEALTH CARE CENTER INC
Practice address
110 Lee Street
Wichita Falls, TX 76301-1152
Phone
(940) 766-6306
Fax
(940) 766-6504
NPI assigned
Dec 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Authorized official

Name
Chad Minnix, CFOO
Title
Cfoo
Phone
(940) 761-1697

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

110 Lee Street
Wichita Falls, TX 76301-1152

Mailing address

200 Martin Luther King Blvd
Wichita Falls, TX 76301-1152
Phone (940) 766-6306

Other names 2

  • Community Healthcare Center-Dental Doing business as
  • Phyllis Hiraki Dental Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220510002686 TX Part A Provider - Federally Qualified Health Center (FQHC) 9931099215 Practice locations: Wichita Falls, TX

Federally qualified health center certification: CCN 451193

Legal name
NORTH CENTRAL TEXAS COMMUNITY HEALTH CARE CENTER INC
Doing business as
PHYLLIS HIRAKI DENTAL CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 10, 2022
Last certification
May 10, 2022
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Apr 7, 1992 in TX
Enrollment address
110 Lee St
Wichita Falls, TX 76301-1128

Other NPIs with the same Medicare PAC ID 13

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

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Nctchcc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Michael Dotson Individual Corporate OfficerCeo Jul 31, 2025 15%
Wesley Holmes Individual Corporate DirectorBoard Member Feb 1, 2020 4%
Holly Scheller Individual Corporate DirectorBoard Member Jul 1, 2023 4%
Nancy C Townley Individual Corporate DirectorBoard Member Jul 1, 2024 4%
Lisa Kimbell Individual Corporate DirectorBoard Member Sep 1, 2024 4%
Barbara a Murphy Individual Corporate DirectorBoard Member Jul 1, 2024 4%
Chad Price Minnix Individual Operational/Managerial ControlChief Financial Officer Aug 26, 2021 15%
Woodrow Gossom Individual Corporate DirectorBoard Member Jul 1, 2023 4%
Virgil Nesbitt Individual Corporate DirectorBoard Member Jul 1, 2020 4%
Ellaheh Ebrahim Individual Operational/Managerial ControlChief Medical Officer Apr 1, 2015 4%
Jeanna Berry Individual Corporate DirectorBoard Member Apr 1, 2024 4%
David a Flack Individual Corporate DirectorBoard Member Jan 1, 2020 4%
Christie Bragg Individual Operational/Managerial ControlAssociate Operations Officer Jul 1, 2016 4%
Kimberly Callahan Individual Corporate DirectorBoard Member Jul 1, 2024 4%
Aaron Goodwin Individual Operational/Managerial ControlChief Information Officer Jul 29, 2015 4%
Debra Yancey Individual Corporate DirectorBoard Member Jul 1, 2023 4%
Richard Bowersock Individual Corporate DirectorBoard Member Jul 1, 2025 4%
Deedee McKinney Individual Operational/Managerial ControlAssociate Operations Officer Oct 19, 2016 4%
Ashvin N Patel Individual Corporate DirectorBoard Member Jul 1, 2016 4%
Iliana Jaramillo Individual Corporate DirectorBoard Member Jul 1, 2017 4%

Owners & managing parties with NPI records 4

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

NPI Registry JSON

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788393600000",
    "number": "1083045454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MARTIN LUTHER KING BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763011152",
            "telephone_number": "940-766-6306",
            "fax_number": "940-766-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LEE STREET",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763011152",
            "telephone_number": "940-766-6306",
            "fax_number": "940-766-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CENTRAL TEXAS COMMUNITY HEALTH CARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-10",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A",
        "authorized_official_last_name": "MINNIX",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CFOO",
        "authorized_official_telephone_number": "940-761-1697",
        "authorized_official_credential": "CFOO"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Healthcare Center-Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Healthcare Center-Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Phyllis Hiraki Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wichita Falls, TX

Sources for this page

Verify at the official NPI Registry.