El Centro del Barrio, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

HBOCS00758-04-00 Issued in TX

Legal business name

EL CENTRO DEL BARRIO, INC.

Doing business as

SAMM Shelter Clinic

Practice address

920 W. Commerce
San Antonio, TX 78207

Phone

(210) 227-2801

Fax

(210) 227-2875

NPI assigned

Nov 17, 2006

Last updated

Mar 23, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Chuck Walzel

Title

Cfo

Phone

(210) 922-0103

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• SAMM Shelter Clinic Doing business as

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237766400000",
    "number": "1083787808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 COMMERCIAL AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782213117",
            "telephone_number": "210-922-0103",
            "fax_number": "210-271-7208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 W. COMMERCE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78207",
            "telephone_number": "210-227-2801",
            "fax_number": "210-227-2875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL CENTRO DEL BARRIO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2009-03-23",
        "status": "A",
        "authorized_official_last_name": "WALZEL",
        "authorized_official_first_name": "CHUCK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "210-922-0103"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "TX",
            "license": "HBOCS00758-04-00",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120980103",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120980101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "00MT08",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120980102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120980105",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAMM Shelter Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• El Centro del Barrio, Inc (CentroMed SA Pediatrics)
• El Centro del Barrio, Inc (CentroMed Indian Creek Clinic)
• El Centro del Barrio, Inc (CentroMed Sarah E. Davidson Clinic)
• El Centro del Barrio, Inc. (CentroMed Elder Care Site)
• El Centro del Barrio, Inc. (RCSA Davidson House)
• El Centro del Barrio, Inc. (CentroMed SA Pediatrics)
• El Centro del Barrio, Inc. (Dullnig House Clinic)
• El Centro del Barrio, Inc. (Infants' Shelter)
• El Centro del Barrio, Inc. (Bexar County Hospital)
• El Centro del Barrio, Inc. (Children's Shelter Clinic)

• Federally Qualified Health Center (FQHC) in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Federally Qualified Health Center (FQHC) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.