NPIMap

Teche Action Board, Inc.

Organization Active NPI Federally Qualified Health Center (FQHC) · Houma, LA

NPI 1215974019 · NPPES record last updated Aug 11, 2025

Key facts

NPI
1215974019
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
TECHE ACTION BOARD, INC.
Practice address
1014 West Tunnel Blvd
Houma, LA 70360-5555
Phone
(985) 851-1717
Fax
(985) 851-7183
NPI assigned
Jun 1, 2006
Organization subpart
Yes
Parent organization (as reported)
TECHE ACTION BOARD, INC.

Authorized official

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

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

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
    CMS ownership CORPORATE DIRECTOR · OPERATIONAL/MANAGERIAL CONTROL · W-2 MANAGING EMPLOYEE

Other NPIs on the same Medicare enrollment 17

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

Other NPIs with the same Medicare PAC ID 11

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

Corporate family (same tax ID) 14

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

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

Practitioners 36

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

View all 36

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in LA

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
Corporation · Non-profit
Incorporated
Oct 1, 1970 in LA
Enrollment address
1014 W Tunnel Blvd
Houma, LA 70360-4050
Related CCNs
191801

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 Director
Board Member		 Dec 31, 2013
Howard Castay
Individual 		Corporate Director
Board Member		 Sep 24, 2010
Berryl Broussard
Individual 		W-2 Managing Employee
Chief Legal Officer		 May 3, 2021
Thomas Dardar
Individual 		Corporate Director
Board Member		 Sep 24, 2010
Barbara Hills
Individual 		Corporate Officer
Secretary		 Sep 24, 2010
Eugene Dial
Individual 		Corporate Director
Board Member		 Jan 3, 2022
Leroy Willis
Individual 		Corporate Officer
President		 Sep 24, 2010
Edna Lyons
Individual 		Corporate Director
Board Member		 Sep 24, 2010
Darrell Jupiter
Individual 		Corporate Director
Board Member		 Dec 5, 2011
Denise Pitts
Individual 		Corporate Director
Board Member		 Dec 5, 2011
Nikina Vilcan
Individual 		W-2 Managing Employee
Cfo		 Aug 3, 2020
Rose Dorsey
Individual 		Corporate Officer
Treasurer		 Sep 24, 2010
Gary M Wiltz
Individual 		Corporate Director
Ceo		 Sep 24, 2010
W-2 Managing Employee
Ceo		 Sep 24, 2010
Operational/Managerial Control
Ceo		 Sep 24, 2010
Donnie Frizzell
Individual 		Corporate Director
Board Member		 Sep 24, 2010
Athan J Olivier
Individual 		W-2 Managing Employee
Coo		 Apr 22, 2025

Medicare enrollment records

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

National Provider Directory

Tax ID family
Teche Action Clinic (15 organizations share this tax ID)
Part of
Teche Action Clinic

Specialties & licenses

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

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 identifiers

IdentifierTypeStateIssuer
5B803OtherLAMEDICARE PART B
1234982MedicaidLA
1452823MedicaidLA

Other names

  • Teche Health @ Houma West Doing business as

Other providers in Houma, LA

All providers in Houma, LA · Federally Qualified Health Center (FQHC) in Louisiana

Sources for this page

Verify at the official NPI Registry.