NPIMap

Organization Active NPI

Health Center of Southeast Texas

  • Clinic Pharmacy
  • Cleveland, TX
National Provider Identifier
1124640347
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
Legal business name
HEALTH CENTER OF SOUTHEAST TEXAS
Practice address
307 N William Barnett Ave
Cleveland, TX 77327-4061
Phone
(281) 592-2224
Fax
(281) 592-2225
NPI assigned
May 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Authorized official

Name
Steven Racciato
Title
Ceo
Phone
(281) 592-2224

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

307 N William Barnett Ave
Cleveland, TX 77327-4061

Mailing address

307 N William Barnett Ave
Cleveland, TX 77327-4061
Phone (281) 592-2224

Other identifiers 1

IdentifierTypeStateIssuer
150640MedicaidTX

Other names 1

  • Health Center of Southeast Texas - Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
Health Center of Southeast6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686614400000",
    "number": "1124640347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 N WILLIAM BARNETT AVE",
            "city": "CLEVELAND",
            "state": "TX",
            "postal_code": "773274061",
            "telephone_number": "281-592-2224",
            "fax_number": "281-592-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 N WILLIAM BARNETT AVE",
            "city": "CLEVELAND",
            "state": "TX",
            "postal_code": "773274061",
            "telephone_number": "281-592-2224",
            "fax_number": "281-592-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH CENTER OF SOUTHEAST TEXAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-11",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A",
        "authorized_official_last_name": "RACCIATO",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "281-592-2224"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150640",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health Center of Southeast Texas - Pharmacy",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Health Center of Southeast Texas - Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cleveland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; 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.