Legacy Community Health Services, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

H80CS07502 Issued in TX

Legal business name

LEGACY COMMUNITY HEALTH SERVICES, INC

Practice address

5515 South Loop East
Houston, TX 77033-1603

Phone

(832) 548-5000

NPI assigned

Jan 27, 2016

Last updated

Jan 9, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Peter Palussek

Title

Coo

Phone

(832) 548-5000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407213085. Details of each certification follow.

• CCN 451051 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 451051

Legal name

LEGACY COMMUNITY HEALTH SERVICES, INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Feb 20, 2019

Last certification

Feb 20, 2019

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Jan 25, 1982 in TX

Enrollment address

5515 South Loop E
Houston, TX 77033-1603

Tax ID family

Legacy Community Healthclosed77 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Legacy Community Health Services, Inc

  dba Legacy Community Health Services Pharmacy - Central Fill

  • Pharmacy
  • Missouri City, TX
  • NPI 1255061040
  NPD tax ID
• Legacy Community Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Houston, TX
  • NPI 1265107528
  NPD tax ID
• Legacy Community Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Houston, TX
  • NPI 1265725949
  NPD tax ID
• Legacy Community Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Houston, TX
  • NPI 1275134595
  NPD tax ID
• Legacy Community Health Services, Inc

  dba Legacy Community Health Services

  • Community/Retail Pharmacy
  • Houston, TX
  • NPI 1295251650
  NPD tax ID
• Legacy Community Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Pasadena, TX
  • NPI 1295683647
  NPD tax ID
• Legacy Community Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Houston, TX
  • NPI 1316545619
  NPD tax ID
• Legacy Community Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Houston, TX
  • NPI 1346993060
  NPD tax ID
• Legacy Community Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Houston, TX
  • NPI 1396098638
  NPD tax ID
• Legacy Community Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Stafford, TX
  • NPI 1407516677
  NPD tax ID
• Legacy Community Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Houston, TX
  • NPI 1407556079
  NPD tax ID
• Legacy Community Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Houston, TX
  • NPI 1427496546
  NPD tax ID

Locations

All disclosed owners & managing parties 14

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

Owners & managing parties with NPI records 2

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

• Tamisha Elise Jones, MD

  • Pediatrics Physician
  • Houston, TX
  • NPI 1033412077

  W-2 Managing Employee

  CMS ownership
• Allison Floyd Wells, M.D.

  • Anesthesiology Physician
  • Spring, TX
  • NPI 1528268117

  Corporate Director

  CMS ownership

All facility ownership & control disclosures 21

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

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.

• Estela Marisol Castillo, LPC

  • Professional Counselor
  • Houston, TX
  • NPI 1093289290
  NPD (past)
• Damien Larkins, M.D.

  • Psychiatry Physician
  • Houston, TX
  • NPI 1487940359
  NPD (past)
• Odalis Lizeth Valdez, FNP

  • Family Nurse Practitioner
  • Houston, TX
  • NPI 1245742758
  NPD (past)
• Kimberly Nguyen Wilkinson, LCSW

  • Clinical Social Worker
  • Houston, TX
  • NPI 1083072797
  NPD (past)
• Antoinette L Wilson, LPC

  • Professional Counselor
  • Houston, TX
  • NPI 1295074110
  NPD (past)

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

{
    "created_epoch": "1453852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1407213085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66308",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772666308",
            "telephone_number": "832-548-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5515 SOUTH LOOP EAST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770331603",
            "telephone_number": "832-548-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY COMMUNITY HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-27",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A",
        "authorized_official_last_name": "PALUSSEK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "832-548-5000"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "TX",
            "license": "H80CS07502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Legacy Community Health Services, Inc
• Legacy Community Health Services, Inc (Legacy Community Health Services)
• Legacy Community Health Services, Inc
• Legacy Community Health Services, Inc
• Legacy Community Health Services, Inc
• Legacy Community Health Services, Inc
• Legacy Community Health Services, Inc
• Legacy Community Health Services, Inc
• Legacy Community Health Services, Inc
• Legacy Community Health Services, Inc

• Federally Qualified Health Center (FQHC) in Houston, TX
• Providers in Houston, TX by specialty
• Federally Qualified Health Center (FQHC) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.