NPIMap

Organization Active NPI

Legacy Community Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Stafford, TX
National Provider Identifier
1407516677
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LEGACY COMMUNITY HEALTH SERVICES, INC
Practice address
12540 Sugardale Dr
Stafford, TX 77477-3702
Phone
(832) 548-5000
Fax
(713) 559-3001
NPI assigned
Dec 29, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

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

Addresses

Primary practice location

12540 Sugardale Dr
Stafford, TX 77477-3702

Mailing address

PO Box 66308
Houston, TX 77266-6308
Phone (832) 548-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220414001164 TX Part A Provider - Federally Qualified Health Center (FQHC) 7911969092 Practice locations: Stafford, TX

Federally qualified health center certification: CCN 451186

Legal name
LEGACY COMMUNITY HEALTH SERVICES, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 8, 2022
Last certification
Apr 8, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 25, 1982 in TX
Enrollment address
12540 Sugardale Dr
Stafford, TX 77477-3702

National Provider Directory

National Provider Directory
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.

View all 24

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
Melisa Garcia Individual W-2 Managing EmployeeSenior VP of Business Services Nov 28, 2007
Allison Wells Individual Corporate DirectorDirector Jan 1, 2021 8.33%
Robert Peter Palussek Individual Corporate OfficerCoo and Interim Ceo Nov 20, 2024
Rebekah Le Individual Corporate DirectorBoard Director Jan 17, 2025 8.33%
Ryan Martin Individual Corporate DirectorChairperson Nov 28, 2018 8.33%
Cathy Easter Individual Corporate DirectorDirector Treasurer Feb 1, 2022 8.33%
Neftali Partida Individual Corporate DirectorDirector Feb 26, 2020 8.33%
Gary Hammett Individual Corporate DirectorDirector Nov 28, 2018 8.33%
Bryan Hlavika Individual Corporate DirectorDirector Apr 1, 2012 8.33%
George Hawkins Individual Corporate DirectorBoard Director Jan 17, 2025 8.33%
Legacy Community Health Services, Inc Organization, Stafford, TX Corporation, Non-profit Operational/Managerial Control Jan 24, 2022 100%
Johnson Olatunji Individual Corporate DirectorDirector Sep 30, 2015 8.33%
Cynthia Scharringhausen Individual Corporate DirectorDirector Dec 1, 2021 8.33%
Ronnie Kurtin Individual Corporate DirectorVice Chairperson Jan 1, 2021 8.33%
Taryn Gore Individual Corporate DirectorDirector Secretary Feb 26, 2020

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 20

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

FacilityTypeRoleSince
Legacy Community Health Services, IncHouston, TX, CCN 671849 Federally qualified health center Operational/Managerial Control (100%) May 15, 2017
Legacy Community Health Services, IncHouston, TX, CCN 671985 Federally qualified health center Operational/Managerial Control (100%) Jul 12, 2012
Legacy Community Health Services, IncHouston, TX, CCN 741844 Federally qualified health center Operational/Managerial Control (100%) May 19, 2017
Legacy Community Health Services, IncHouston, TX, CCN 741923 Federally qualified health center Operational/Managerial Control (100%) Jul 21, 2015
N/aHouston, TX, CCN 741951 Federally qualified health center Operational/Managerial Control (100%) May 19, 2017
N/aDeer Park, TX, CCN 741954 Federally qualified health center Operational/Managerial Control (100%) May 22, 2017
N/aBeaumont, TX, CCN 451012 Federally qualified health center Operational/Managerial Control (100%) Jul 9, 2018
Legacy Community Health Services, IncHouston, TX, CCN 451187 Federally qualified health center Operational/Managerial Control (100%) Aug 9, 2021
Legacy Community Health Services, IncHouston, TX, CCN 451188 Federally qualified health center Operational/Managerial Control (100%) Aug 1, 2021
Legacy Community Health Services, IncHouston, TX, CCN 671015 Federally qualified health center Operational/Managerial Control (100%) May 16, 2022
Legacy Community Health Services, IncHouston, TX, CCN 671016 Federally qualified health center Operational/Managerial Control (100%) Aug 15, 2022
Legacy Community Health Services, IncHouston, TX, CCN 671020 Federally qualified health center Operational/Managerial Control (100%) Aug 23, 2022
Legacy Community Health Services, IncMissouri City, TX, CCN 971002 Federally qualified health center Operational/Managerial Control (100%) Nov 1, 2022
Legacy Community Health Services, IncBeaumont, TX, CCN 451907 Federally qualified health center Operational/Managerial Control (100%) Dec 19, 2022
N/aHouston, TX, CCN 671121 Federally qualified health center Operational/Managerial Control (100%) Aug 17, 2023
Legacy Community Health Services, IncBaytown, TX, CCN 671128 Federally qualified health center Operational/Managerial Control (100%) Aug 29, 2023
Legacy Community Health Services, IncHouston, TX, CCN 971012 Federally qualified health center Operational/Managerial Control (100%) Jun 7, 2024
Legacy Community Health Services, IncHouston, TX, CCN 971086 Federally qualified health center Operational/Managerial Control (100%) Sep 23, 2025
Legacy Community Health Services, IncHouston, TX, CCN 971085 Federally qualified health center Operational/Managerial Control (100%) Sep 23, 2025
Legacy Community Health Services, IncPasadena, TX, CCN 971090 Federally qualified health center Operational/Managerial Control (100%) Oct 14, 2025

Facilities with the same owner 20

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 20

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1640736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1407516677",
    "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",
            "fax_number": "713-559-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12540 SUGARDALE DR",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774773702",
            "telephone_number": "832-548-5000",
            "fax_number": "713-559-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY COMMUNITY HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-29",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, TX

Sources for this page

Verify at the official NPI Registry.