NPIMap

Organization Active NPI

Stephen F Austin Community Health Center, Inc.

Doing business as Brazoria County Dream Center Integrated Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Clute, TX
National Provider Identifier
1417414343
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
STEPHEN F AUSTIN COMMUNITY HEALTH CENTER, INC.
Doing business as
Brazoria County Dream Center Integrated Health Clinic
MyCHN Clute
Practice address
792 S Hwy 288-B
Clute, TX 77531-5712
Phone
(281) 824-1480
NPI assigned
Feb 27, 2019
Last updated
Oct 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Authorized official

Name
Linh Tran
Title
Cfo
Phone
(281) 919-4789

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

792 S Hwy 288-B
Clute, TX 77531-5712

Mailing address

1111 W Adoue St
Alvin, TX 77511-2718
Phone (281) 824-1480

Other names 2

  • Brazoria County Dream Center Integrated Health Clinic Doing business as
  • MyCHN Clute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190729000537 TX Part A Provider - Federally Qualified Health Center (FQHC) 6204977127 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clute, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417414343. Details of each certification follow.

Federally qualified health center certification: CCN 451070

Legal name
STEPHEN F AUSTIN COMMUNITY HEALTH CENTER, INC.
Doing business as
BRAZORIA COUNTY DREAM CENTER INTEGRATED HEALTH CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 17, 2019
Last certification
Jul 17, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 12, 2008 in TX
Enrollment address
792 S Hwy 288-B
Clute, TX 77531-5712

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
CHN Pharmacy28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Locations

792 Highway 288 S
#B
Clute, TX 77531

905 N Gulf Blvd
Freeport, TX 77541
Phone (979) 233-6297

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Marbella Hooper Individual Corporate DirectorBoard Member Secretary Aug 1, 2017
Brandy Smith Individual W-2 Managing EmployeeCredentialing Coordinator Apr 7, 2016
Mark Young Individual 5% Or Greater Indirect Ownership InterestCeo Apr 1, 2010
Corporate OfficerCeo Apr 1, 2010
Corporate DirectorCeo Apr 1, 2010
Debra Fontenot Individual Corporate DirectorBoard Member Aug 21, 2018
Ronald Medina Individual Corporate DirectorBoard Member Oct 20, 2015
Bonnie Horton Individual Corporate DirectorBoard Member Apr 8, 2008
Gerald Roznovsky Individual Corporate DirectorBoard Member, Chairman Apr 8, 2008
Gina Adams Individual Corporate DirectorBoard Member Vice Chair Jan 1, 2015

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": "1551225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761091200000",
    "number": "1417414343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W ADOUE ST",
            "city": "ALVIN",
            "state": "TX",
            "postal_code": "775112718",
            "telephone_number": "281-824-1480",
            "fax_number": "281-220-6407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "792 S HWY 288-B",
            "city": "CLUTE",
            "state": "TX",
            "postal_code": "775315712",
            "telephone_number": "281-824-1480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN F AUSTIN COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-27",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "LINH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "281-919-4789"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brazoria County Dream Center Integrated Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MyCHN Clute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clute, TX

Sources for this page

Verify at the official NPI Registry.