NPIMap

Organization Active NPI

Community Health Centers of South Central Texas Inc

Doing business as Seguin Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Seguin, TX
National Provider Identifier
1285893131
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS INC
Doing business as
Seguin Community Health Center
Seguin Family Health Center
Practice address
1104 Jefferson St.
Seguin, TX 78155-5910
Phone
(830) 379-9797
Fax
(830) 379-0248
NPI assigned
Jun 5, 2008
Last updated
Sep 3, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Authorized official

Name
Rafael De la Paz
Title
Ceo
Phone
(830) 672-6511

Specialties & licenses 1

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

Addresses

Primary practice location

1104 Jefferson St.
Seguin, TX 78155-5910

Mailing address

PO Box 1890
Gonzales, TX 78629-1390
Phone (830) 672-6511

Other identifiers 4

IdentifierTypeStateIssuer
00HE62OtherTXBLUE CROSS BLUE SHIELD
192800401MedicaidTX
121440502MedicaidTX
083010101MedicaidTX

Other names 2

  • Seguin Community Health Center Doing business as
  • Seguin Family Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080429000465 TX Part A Provider - Federally Qualified Health Center (FQHC) 4688650328 1 other NPI on this enrollment
Practice locations: Seguin, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285893131. Details of each certification follow.

Federally qualified health center certification: CCN 671895

Legal name
COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 10, 2008
Last certification
Sep 10, 2008
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
1104 Jefferson Ave
Seguin, TX 78155-5910

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 1

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
45D1068109Seguin Family Health Center1104 Jefferson Street, Seguin, TX 78155Certificate of waiverMar 20, 2028

National Provider Directory

National Provider Directory
Tax ID family
Gonzales County Health6 organizations share this tax ID, including this one
Part of
Gonzales County Health

Other organizations with this tax ID 5

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

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
Daniel Kleiner Individual Corporate DirectorBoard Member Sep 10, 2018
Dorothy Eberle Individual Corporate DirectorSecretary Feb 26, 2008
Lisa Burns Individual Corporate DirectorCommunity Representative Apr 22, 2013
Rafael Delapaz Individual Corporate OfficerCeo Jan 1, 2019
W-2 Managing EmployeeCeo Oct 5, 2009
Rosie Flores Individual Corporate DirectorVice President Feb 26, 2008
Charlie Patterson Individual Corporate DirectorPresident Jul 1, 2013
Raziel Delabarreda Individual Corporate OfficerCoo Jul 27, 2017
W-2 Managing EmployeeCoo Oct 1, 2010
Gary Clack Individual Corporate DirectorCommunity Representative Jan 25, 2022
Phillip Borowitz Individual Corporate DirectorCommunity Representative Feb 26, 2008
Rhonda Hunnicutt Individual Corporate DirectorCommunity Representative Nov 15, 2022

Practitioners & affiliated clinicians

Practitioners 1

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": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599091200000",
    "number": "1285893131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1890",
            "city": "GONZALES",
            "state": "TX",
            "postal_code": "786291390",
            "telephone_number": "830-672-6511",
            "fax_number": "830-672-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 JEFFERSON ST.",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781555910",
            "telephone_number": "830-379-9797",
            "fax_number": "830-379-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS INC",
        "enumeration_date": "2008-06-05",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A",
        "authorized_official_last_name": "DE LA PAZ",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "830-672-6511"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00HE62",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192800401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121440502",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "083010101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seguin Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Seguin Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Seguin Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seguin, TX

Sources for this page

Verify at the official NPI Registry.