NPIMap

Organization Active NPI

Spring Branch Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Houston, TX
National Provider Identifier
1093186728
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SPRING BRANCH COMMUNITY HEALTH CENTER
Practice address
1905 Jacquelyn Dr # 101
Houston, TX 77055-2502
Phone
(713) 462-6565
Fax
(713) 732-9665
NPI assigned
Oct 7, 2015
Last updated
Jun 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Authorized official

Name
Marlen J Tujillo, MBA
Title
Chief Executive Officer
Phone
(713) 462-6565

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X NU
Pediatrics Physician 208000000X NU
Community Health Worker 172V00000X NU

Addresses

Primary practice location

1905 Jacquelyn Dr # 101
Houston, TX 77055-2502

Mailing address

5502 1St St
Katy, TX 77493-2472
Phone (713) 462-6565

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Houston Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040505001669 TX Part B Supplier - Clinic/Group Practice 3072501154 Receives reassigned benefits from 82 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cypress, TX; Katy, TX; Houston, TX
O20170812000011 TX Part A Provider - Federally Qualified Health Center (FQHC) 3072501154 Practice locations: Houston, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093186728. Details of each certification follow.

Federally qualified health center certification: CCN 741965

Legal name
SPRING BRANCH COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 8, 2017
Last certification
Aug 8, 2017
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Jul 14, 2003 in TX
Enrollment address
1905 Jacquelyn Dr
Ste 101
Houston, TX 77055-2502

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 7

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

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
45D2123993Spring Branch Community Health Center1905 Jacquelyn Rd, Ste 101, Houston, TX 77055Provider-performed microscopyAug 6, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Spring Branch Community Health Center Organization, Katy, TX Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2016
Michael Bsaibes Individual Corporate OfficerCoo Oct 15, 2007
John Kemper Individual Corporate OfficerBoard Treasurer Apr 23, 2013
Marlen J Trujillo Individual Corporate DirectorCeo Mar 1, 2006
W-2 Managing EmployeeCeo Mar 1, 2006

Owners & managing parties with NPI records 8

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Spring Branch Community Health CenterKaty, TX, CCN 741861 Federally qualified health center 5% Or Greater Direct Ownership Interest Aug 18, 2014
Spring Branch Community Health CenterHouston, TX, CCN 741866 Federally qualified health center 5% Or Greater Direct Ownership Interest Aug 18, 2014
Spring Branch Community Health CenterHouston, TX, CCN 451196 Federally qualified health center Operational/Managerial Control Mar 1, 2006

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750377600000",
    "number": "1093186728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5502 1ST ST",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774932472",
            "telephone_number": "713-462-6565",
            "fax_number": "832-831-5369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 JACQUELYN DR # 101",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770552502",
            "telephone_number": "713-462-6565",
            "fax_number": "713-732-9665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING BRANCH COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A",
        "authorized_official_last_name": "TUJILLO",
        "authorized_official_first_name": "MARLEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "713-462-6565",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Houston",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1905 Jacquelyn Dr # 101",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770552502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.