NPIMap

Organization Active NPI

Teche Action Board, Inc.

Doing business as Teche Health @ Houma West

  • Federally Qualified Health Center (FQHC)
  • Houma, LA
National Provider Identifier
1215974019
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
TECHE ACTION BOARD, INC.
Doing business as
Teche Health @ Houma West
Practice address
1014 West Tunnel Blvd
Houma, LA 70360-5555
Phone
(985) 851-1717
Fax
(985) 851-7183
NPI assigned
Jun 1, 2006
Last updated
Aug 11, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
TECHE ACTION BOARD, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Authorized official

Name
Mr. Gary M Wiltz, MDNPI 1477596351
Title
Ceo
Phone
(337) 828-2550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1014 West Tunnel Blvd
Houma, LA 70360-5555

Mailing address

1115 Weber Street
Franklin, LA 70538-4124
Phone (337) 828-2550

Other names 1

  • Teche Health @ Houma West Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041109000792 LA Part B Supplier - Clinic/Group Practice 0648163980 Receives reassigned benefits from 39 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: La Place, LA; Vacherie, LA; Thibodaux, LA; Reserve, LA; Pierre Part, LA; Morgan City, LA; Houma, LA; Gramercy, LA…
O20101122001425 LA Part A Provider - Federally Qualified Health Center (FQHC) 0648163980 Practice locations: Houma, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215974019. Details of each certification follow.

Federally qualified health center certification: CCN 191848

Legal name
TECHE ACTION BOARD INC
Doing business as
TECHE HEALTH @ HOUMA WEST
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 21, 2006
Last certification
Mar 21, 2006
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1970 in LA
Enrollment address
1014 W Tunnel Blvd
Houma, LA 70360-4050
Related CCNs
191801

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 11

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

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 17

National Provider Directory

National Provider Directory
Tax ID family
Lisa C Southall16 organizations share this tax ID, including this one
Part of
Lisa C Southall

Other organizations with this tax ID 15

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

View all 15

Locations

149 E 3rd St
Edgard, LA 70049

22187 Highway 20
Vacherie, LA 70090
Phone (225) 258-4980

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Willie Rack Individual Corporate DirectorBoard Member Dec 31, 2013
Howard Castay Individual Corporate DirectorBoard Member Sep 24, 2010
Berryl Broussard Individual W-2 Managing EmployeeChief Legal Officer May 3, 2021
Thomas Dardar Individual Corporate DirectorBoard Member Sep 24, 2010
Barbara Hills Individual Corporate OfficerSecretary Sep 24, 2010
Eugene Dial Individual Corporate DirectorBoard Member Jan 3, 2022
Leroy Willis Individual Corporate OfficerPresident Sep 24, 2010
Edna Lyons Individual Corporate DirectorBoard Member Sep 24, 2010
Darrell Jupiter Individual Corporate DirectorBoard Member Dec 5, 2011
Denise Pitts Individual Corporate DirectorBoard Member Dec 5, 2011
Nikina Vilcan Individual W-2 Managing EmployeeCfo Aug 3, 2020
Rose Dorsey Individual Corporate OfficerTreasurer Sep 24, 2010
Gary M Wiltz Individual Corporate DirectorCeo Sep 24, 2010
W-2 Managing EmployeeCeo Sep 24, 2010
Operational/Managerial ControlCeo Sep 24, 2010
Donnie Frizzell Individual Corporate DirectorBoard Member Sep 24, 2010
Athan J Olivier Individual W-2 Managing EmployeeCoo Apr 22, 2025

Owners & managing parties with NPI records 1

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

  • Gary M Wiltz, M.D.
    • Internal Medicine Physician
    • Franklin, LA
    • NPI 1477596351

    Corporate Director, Operational/Managerial Control, W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 33

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.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1215974019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 WEBER STREET",
            "city": "FRANKLIN",
            "state": "LA",
            "postal_code": "705384124",
            "telephone_number": "337-828-2550",
            "fax_number": "337-355-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 WEST TUNNEL BLVD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703605555",
            "telephone_number": "985-851-1717",
            "fax_number": "985-851-7183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TECHE ACTION BOARD, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TECHE ACTION BOARD, INC.",
        "enumeration_date": "2006-06-01",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "WILTZ",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-828-2550",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "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": "Teche Health @ Houma West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houma, LA

Sources for this page

Verify at the official NPI Registry.