NPIMap

Organization Active NPI

Atascosa Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Tilden, TX
National Provider Identifier
1164899472
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ATASCOSA HEALTH CENTER, INC.
Practice address
203 Hackberry St.
Tilden, TX 78072
Phone
(361) 274-3690
Fax
(361) 274-3760
NPI assigned
Aug 24, 2015
Organization subpart
Yes
Parent organization
ATASCOSA HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Authorized official

Name
Monty Small, CMPE
Title
Chief Executive Officer
Phone
(830) 569-8940

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

203 Hackberry St.
Tilden, TX 78072

Mailing address

310 W Oaklawn Rd
Pleasanton, TX 78064-4033
Phone (830) 569-8940

Other names 1

  • MCMULLEN COMMUNITY HEALTH CENTER Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040420001663 TX Part B Supplier - Clinic/Group Practice 3779579412 Receives reassigned benefits from 25 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Poteet, TX; Three Rivers, TX; Tilden, TX; Lytle, TX; Karnes City, TX; Floresville, TX; Pleasanton, TX
O20160203001510 TX Part A Provider - Federally Qualified Health Center (FQHC) 3779579412 Practice locations: Tilden, TX

Federally qualified health center certification: CCN 741917

Legal name
ATASCOSA HEALTH CENTER, INC.
Doing business as
MCMULLEN COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 2, 2016
Last certification
Feb 2, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 7, 1997 in TX
Enrollment address
203 Hackberry St
Tilden, TX 78072

Other NPIs with the same Medicare PAC ID 7

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
45D2102360Atascosa Health Center Inc203 Hackberry Street, Tilden, TX 78072Certificate of waiverSep 21, 2027

National Provider Directory

National Provider Directory
Tax ID family
Atascosa Health Center8 organizations share this tax ID, including this one
Part of
Atascosa Health Center

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Virginia Herring Individual Corporate DirectorVolunteer Board Member Jul 27, 2017
Lillian R Cashmer Individual Corporate DirectorVolunteer Board Member Oct 3, 2008
Kara Luna Individual Corporate DirectorVolunteer Board Member Sep 28, 2017
Carlos Vidal Munoz Individual Corporate DirectorVolunteer Board Member Sep 28, 2017
Monty B Small Individual Corporate OfficerChief Executive Officer Sep 1, 2004
W-2 Managing EmployeeChief Executive Officer Aug 26, 2015
Lillian W Lyssey Individual Corporate DirectorVolunteer Board Member Oct 1, 2008
James Teal Individual Corporate OfficerVolunteer Board Member May 22, 2014
Corporate DirectorVolunteer Board Member May 22, 2014
Dwayne Villanueva Individual Corporate DirectorVolunteer Board Member Jan 5, 2010
Tammy H Favor Individual Corporate DirectorVolunteer Board Member Mar 28, 2013
Henry Salas Individual Corporate DirectorVolunteer Board Member Sep 28, 2017
Maria Garcia Individual Corporate OfficerChief Financial Officer Feb 1, 2005
W-2 Managing EmployeeChief Financial Officer Aug 26, 2015
Rosario C Oropeza Individual Corporate DirectorVolunteer Board Member May 13, 2021

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756339200000",
    "number": "1164899472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 W OAKLAWN RD",
            "city": "PLEASANTON",
            "state": "TX",
            "postal_code": "780644033",
            "telephone_number": "830-569-8940",
            "fax_number": "830-569-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 HACKBERRY ST.",
            "city": "TILDEN",
            "state": "TX",
            "postal_code": "78072",
            "telephone_number": "361-274-3690",
            "fax_number": "361-274-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATASCOSA HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATASCOSA HEALTH CENTER, INC.",
        "enumeration_date": "2015-08-24",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A",
        "authorized_official_last_name": "SMALL",
        "authorized_official_first_name": "MONTY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "830-569-8940",
        "authorized_official_credential": "CMPE"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCMULLEN COMMUNITY HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MCMULLEN COMMUNITY HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tilden, TX

Sources for this page

Verify at the official NPI Registry.