NPIMap

Organization Active NPI

Stephen F Austin Community Health Center,Inc

  • Community/Retail Pharmacy
  • Houston, TX
National Provider Identifier
1154909323
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
STEPHEN F AUSTIN COMMUNITY HEALTH CENTER,INC
Practice address
10851 Scarsdale Blvd Ste 160B
Houston, TX 77089-5737
Phone
(281) 824-1480
Fax
(281) 220-6407
NPI assigned
Mar 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Authorized official

Name
Brandy Smith
Title
Credentialing Coordinator
Phone
(281) 824-1480

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Community/Retail Pharmacy 3336C0003X Primary
Home Infusion Therapy Pharmacy 3336H0001X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

10851 Scarsdale Blvd Ste 160B
Houston, TX 77089-5737

Mailing address

10851 Scarsdale Blvd Ste 160B
Houston, TX 77089-5737
Phone (281) 824-1480

Other names 1

  • CHN Pharmacy #300 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240322002101 TX Part B Supplier - Pharmacy 6204977127 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

Other NPIs with the same Medicare PAC ID 14

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

View all 14

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Stephen F Austin Community Health Center, Inc.Alvin, TX, CCN 671934 Federally qualified health center Operational/Managerial Control Nov 24, 2009
Mychn CallawayAlvin, TX, CCN 741976 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 2017
Women and Children'S Health CenterAlvin, TX, CCN 451000 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 3, 2016
Pearland Family Health CenterPearland, TX, CCN 451039 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 9, 2018
Mychn WebsterWebster, TX, CCN 971091 Federally qualified health center 5% Or Greater Direct Ownership Interest Feb 16, 2017

Owned or controlled facilities with NPI records 5

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

Practitioners & affiliated clinicians

Practitioners 95

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 95

NPI Registry JSON

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704672000000",
    "number": "1154909323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10851 SCARSDALE BLVD STE 160B",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770895737",
            "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": "10851 SCARSDALE BLVD STE 160B",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770895737",
            "telephone_number": "281-824-1480",
            "fax_number": "281-220-6407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN F AUSTIN COMMUNITY HEALTH CENTER,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-30",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-04",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "281-824-1480"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHN Pharmacy #300",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHN Pharmacy #300",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.