Amistad Community Health Center Incorporated
Organization Active NPI Federally Qualified Health Center (FQHC) · Aransas Pass, TX
NPI 1346056546 · NPPES record last updated Apr 3, 2025
Key facts
- NPI
- 1346056546
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- AMISTAD COMMUNITY HEALTH CENTER INCORPORATED
- Practice address
- 1711 W Wheeler Ave Ste 3
Aransas Pass, TX 78336-4565 - Phone
- (361) 884-2242
- Fax
- (361) 884-2243
- NPI assigned
- Dec 4, 2024
- Organization subpart
- Yes
- Parent organization (as reported)
- AMISTAD COMMUNITY HEALTH CENTER INCORPORATED
Authorized official
- Name
- Mrs. Tamiko Rochell Richardson
- Title
- Revenue Cycle and Compliance Coord
- Phone
- (903) 736-2577
Owners & managing parties with NPI records 1
Owned or controlled facilities with NPI records 2
Other NPIs with the same Medicare PAC ID 6
Corporate family (same tax ID) 7
Practitioners 27
-
Elizabeth Granados Chavarria, APRN, FNP-C
-
Telisha Bernal, FNP
-
Chelsea Rhiannon Bueno, FNP-C
-
William Mattew Dennis, M.D.
-
Luis Fuentes III, D.O.
-
Nelly Ivonne Garcia Blow, D.O.
-
Lisette Anahi Garcia, LPC
-
David Aaron Guerra, APRN, FNP-BC
-
Riley Diane Huerta, LPC
-
Scott P Krall, MD
-
Elizabeth Ann Loika, ARNP
-
Danea Mickey, LPC
-
Karim N Nooruddin, M.D.
-
Kimberly Renee Price, FNP
-
Leticia M Reyes, LPC
-
Judith E Rubano, MD
-
Jefryn Porter Sellers, FNP-C
-
Lisa Marie Vela, MD
-
Janalee Webb, CNP
-
Molly West, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Federally qualified health center certification: CCN 971074
- Legal name
- AMISTAD COMMUNITY HEALTH CENTER INCORPORATED
- Doing business as
- AMISTAD HEALTH
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jul 28, 2025
- Last certification
- Jul 28, 2025
- Ownership / control type
- For profit – corporation
- Organization structure
- Other · Non-profit
- Enrollment address
- 1711 W Wheeler Ave
Ste 3
Aransas Pass, TX 78336-4565
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| Susanne Wood |
Other |
Jul 1, 2023 | |
| Steven Leon Gates |
Other |
Feb 1, 2019 | |
| Pamela Brower |
Other |
Aug 1, 2023 | |
| Christine Nicosia |
Other |
Nov 1, 2023 | |
| Esther Jones |
Other |
Feb 1, 2019 | |
| Tamiko Richardson |
W-2 Managing Employee |
Aug 1, 2024 | |
| Other |
Aug 1, 2024 | ||
| Suzelle Tinnell |
Other |
Jan 1, 2021 | |
| Mark Meyer |
Other |
Feb 1, 2018 | |
| Alfred Martinez |
Other |
Aug 1, 2024 | |
| Diana Rivers |
Other |
Aug 1, 2019 | |
| Eric Baggerman |
Corporate Officer |
Jan 29, 2024 | |
| W-2 Managing Employee | Sep 1, 2024 | ||
| Nicholas L Adame |
Other |
Aug 1, 2018 | |
| Angela Leal |
Other |
Dec 1, 2021 |
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Rcm360 LLC |
Federally qualified health center | Operational/Managerial Control | Jan 1, 2020 |
| Amistad Community Health Center Incorporated |
Federally qualified health center | Operational/Managerial Control | Nov 1, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250917000976 | TX | Part a Provider - Federally Qualified Health Center (FQHC) | 8527131036 | Practice locations: Aransas Pass, TX |
National Provider Directory
- Tax ID family
- Amistad Comm HLTH Ctr Inc
- Part of
- Amistad Comm HLTH Ctr Inc
Locations
1711 W Wheeler Ave
Ste 1
Aransas Pass, TX 78336
Phone (361) 229-3178
1533 S Brownlee Blvd
#100
Corpus Christi, TX 78404
Phone (361) 884-2242
7017 S Staples St
Ste 101
Corpus Christi, TX 78413
Phone (361) 884-2422
814 E Main Ave
Ste 100
Robstown, TX 78380
Phone (361) 886-3040
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes | ||
| Multi-Specialty Clinic/Center | 261QM1300X |
Addresses
Primary practice location
1711 W Wheeler Ave Ste 3
Aransas Pass, TX 78336-4565
Mailing address
1533 S Brownlee Blvd
Corpus Christi, TX 78404-3131
Phone (361) 884-2242
Other names
- Amistad Health
Other providers in Aransas Pass, TX
- Alamgir Khan MD PLLC
- Always First Home Care LLC
- Amistad Community Health Center Incorporated
- Anchor Clanker Inc
- Ap Wellness Clinic for Women, Inc.
- Aransas Dental PLLC
- Aransas Family Chiropractic Inc
- Aransas Pass Ind School Dist
All providers in Aransas Pass, TX · Federally Qualified Health Center (FQHC) in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.