NPIMap

Organization Active NPI

Special Health Resources for Texas, Incorporated

Doing business as Tyler Care Clinic

  • Federally Qualified Health Center (FQHC)
  • Tyler, TX
National Provider Identifier
1184103285
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SPECIAL HEALTH RESOURCES FOR TEXAS, INCORPORATED
Doing business as
Tyler Care Clinic
Tyler Women and Childrens Clinic
Practice address
4519 Troup Hwy
Tyler, TX 75703-2350
Phone
(903) 289-9252
Fax
(903) 630-5456
NPI assigned
Aug 9, 2018
Last updated
Nov 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Authorized official

Name
Jessica Roldan
Title
Ceo
Phone
(903) 234-0776

Specialties & licenses 1

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

Addresses

Primary practice location

4519 Troup Hwy
Tyler, TX 75703-2350

Mailing address

PO Box 2709
Longview, TX 75606-2709
Phone (903) 234-0776

Other names 2

  • Tyler Care Clinic Doing business as
  • Tyler Women and Childrens Clinic Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040623001434 TX Part B Supplier - Clinic/Group Practice 1355326158 Receives reassigned benefits from 22 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Texarkana, TX; Tyler, TX; Paris, TX; Longview, TX; Jacksonville, TX
O20181016000873 TX Part A Provider - Federally Qualified Health Center (FQHC) 1355326158 Practice locations: Tyler, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184103285. Details of each certification follow.

Federally qualified health center certification: CCN 451017

Legal name
SPECIAL HEALTH RESOURCES FOR TEXAS, INCORPORATED
Doing business as
TYLER CARE CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 15, 2018
Last certification
Oct 15, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 10, 1991 in TX
Enrollment address
4519 Troup Hwy
Tyler, TX 75703-2350

Other NPIs with the same Medicare PAC ID 10

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.

National Provider Directory

National Provider Directory
Tax ID family
Special Health Resources for Texas Incorporated11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

1011 College Ave
Jacksonville, TX 75766
Phone (903) 541-2577

402 N 7th St
Longview, TX 75601
Phone (903) 212-7170

3150 Clarksville St
Paris, TX 75460
Phone (903) 784-2571

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Roger Gardner Individual Corporate DirectorBoard Member Jun 25, 2019
Special Health Resources for Texas, Incorporated Organization, Tyler, TX Corporation, Non-profit Operational/Managerial Control Jan 10, 1991
Briana Asberry Individual Corporate DirectorBoard Member Mar 2, 2021
Danny Rivers Individual Corporate DirectorBoard Treasurer May 29, 2018
Pamela Lewis Individual Corporate DirectorBoard Member Jun 30, 2020
Jessica Roldan Individual Corporate OfficerCeo Sep 9, 2024
Corporate DirectorCeo Sep 9, 2024
W-2 Managing EmployeeCeo Sep 9, 2024
Lupe Tobar Individual Corporate DirectorBoard Chair Jun 30, 2020
Bobby Pierce Individual Corporate DirectorBoard Vice Chair Sep 25, 2018
Janine Wood Individual Corporate DirectorBoard Secretary Sep 24, 2019
Roque Capetillo Individual Corporate DirectorBoard Member Jun 30, 2020

Owners & managing parties with NPI records 10

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

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Midtown Clinic of TylerTyler, TX, CCN 741903 Federally qualified health center Other Jan 10, 1991
Special Health Resources for Texas, IncorporatedTexarkana, TX, CCN 741905 Federally qualified health center Operational/Managerial Control Jan 10, 1991
All for Kids ClinicTexarkana, AR, CCN 041916 Federally qualified health center Other Jan 4, 2016
Special Health Resources for Texas, IncorporatedLongview, TX, CCN 741936 Federally qualified health center Other Nov 16, 2016
Paris ClinicParis, TX, CCN 741977 Federally qualified health center Other Nov 20, 2017

Owned or controlled facilities with NPI records 5

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 5

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": "1533772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763424000000",
    "number": "1184103285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2709",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756062709",
            "telephone_number": "903-234-0776",
            "fax_number": "903-234-9769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4519 TROUP HWY",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757032350",
            "telephone_number": "903-289-9252",
            "fax_number": "903-630-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIAL HEALTH RESOURCES FOR TEXAS, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-09",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A",
        "authorized_official_last_name": "ROLDAN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "903-234-0776"
    },
    "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": "Tyler Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tyler Women and Childrens Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.