NPIMap

Organization Active NPI

Stephen F Austin Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lake Jackson, TX
National Provider Identifier
1144905415
Registry record updated Nov 25, 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.
Practice address
120 Flag Lake Dr Ste 2
Lake Jackson, TX 77566-6292
Phone
(281) 824-1480
Fax
(281) 220-6407
NPI assigned
Jun 15, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Authorized official

Name
Courtney Gaines
Title
Credentialing Coordinator II
Phone
(281) 824-1480

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

120 Flag Lake Dr Ste 2
Lake Jackson, TX 77566-6292

Mailing address

1612 Callaway Dr
Alvin, TX 77511-3743
Phone (281) 824-1480

Other practice location 1

1111 W Adoue St
Alvin, TX 77511-2718
Phone (281) 824-1480

Other names 2

  • MYCHN LAKE JACKSON Doing business as
  • MYCHN LAKEJACKSON 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
45D2280601Mychn Lake Jackson120 Flag Lake Dr Ste 2, Lake Jackson, TX 77566Certificate of waiverApr 20, 2027

National Provider Directory

National Provider Directory
Tax ID family
CHN Pharmacy25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

Locations

120 Flag Lake Dr
Ste 2
Lake Jackson, TX 77566
Phone (979) 297-7555

NPI Registry JSON

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764028800000",
    "number": "1144905415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 CALLAWAY DR",
            "city": "ALVIN",
            "state": "TX",
            "postal_code": "775113743",
            "telephone_number": "281-824-1480",
            "fax_number": "281-220-6407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 FLAG LAKE DR STE 2",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775666292",
            "telephone_number": "281-824-1480",
            "fax_number": "281-220-6407"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 W Adoue St",
            "address_purpose": "LOCATION",
            "city": "Alvin",
            "state": "TX",
            "postal_code": "775112718",
            "country_code": "US",
            "telephone_number": "281-824-1480",
            "fax_number": "281-220-6407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STEPHEN F AUSTIN COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-15",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A",
        "authorized_official_last_name": "GAINES",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR II",
        "authorized_official_telephone_number": "281-824-1480"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MYCHN LAKE JACKSON",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MYCHN LAKEJACKSON",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MYCHN LAKEJACKSON",
            "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 25, 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.