NPIMap

Organization Active NPI

Stephen F Austin Community Health Center, Inc

Doing business as MyCHN KIDS WAY

  • Federally Qualified Health Center (FQHC)
  • Lake Jackson, TX
National Provider Identifier
1083574842
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
STEPHEN F AUSTIN COMMUNITY HEALTH CENTER, INC
Doing business as
MyCHN KIDS WAY
Practice address
210 Lake Rd Ste 800B
Lake Jackson, TX 77566-4983
Phone
(281) 824-1480
NPI assigned
Nov 14, 2025
Last updated
Nov 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Authorized official

Name
Mark D Young
Title
Ceo
Phone
(281) 824-1480

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

210 Lake Rd Ste 800B
Lake Jackson, TX 77566-4983

Mailing address

1111 W Adoue St
Alvin, TX 77511-2718

Other names 1

  • MyCHN KIDS WAY Doing business as

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
45D2334036Mychn Kids Way210 Lake Rd # 800B, Lake Jackson, TX 77566Certificate of waiverNov 13, 2027

National Provider Directory

National Provider Directory
Tax ID family
CHN Pharmacy28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Locations

210 Lake Rd
Ste 800B
Lake Jackson, TX 77566
Phone (979) 299-6400

NPI Registry JSON

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

{
    "created_epoch": "1763078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763078400000",
    "number": "1083574842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W ADOUE ST",
            "city": "ALVIN",
            "state": "TX",
            "postal_code": "775112718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 LAKE RD STE 800B",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775664983",
            "telephone_number": "281-824-1480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN F AUSTIN COMMUNITY HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-14",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "281-824-1480"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyCHN KIDS WAY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Jackson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.