NPIMap

Organization Active NPI

Su Clinica Familiar

  • Federally Qualified Health Center (FQHC)
  • Harlingen, TX
National Provider Identifier
1427071968
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SU CLINICA FAMILIAR
Practice address
1706 Treasure Hills Blvd
Harlingen, TX 78550-8911
Phone
(956) 365-6750
Fax
(956) 365-6779
NPI assigned
Jul 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Mr. Adam Saldivar
Title
Cfo
Phone
(956) 365-6750

Specialties & licenses 1

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

Addresses

Primary practice location

1706 Treasure Hills Blvd
Harlingen, TX 78550-8911

Mailing address

1706 Treasure Hills Blvd
Harlingen, TX 78550-8911
Phone (956) 365-6750

Other identifiers 1

IdentifierTypeStateIssuer
019025801MedicaidTX

Other names 1

  • WOMENS HEALTH CENTER Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030617000007 TX Part A Provider - Federally Qualified Health Center (FQHC) 5496663429 Practice locations: Harlingen, TX

Federally qualified health center certification: CCN 451826

Legal name
SU CLINICA FAMILIAR
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 19, 1980 in TX
Enrollment address
1706 Treasure Hills Blvd
Harlingen, TX 78550-8911

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Suclinica Familiar15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

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
Esmeralda Cisneros Individual Corporate Director Jun 28, 2018
Dorathy Garza Individual Corporate Director Jun 28, 2018
Christina Garcia Individual Corporate Director Jun 29, 2017
Jose Adam Saldivar Individual Corporate OfficerChief Financial Officer Dec 12, 2005
Rosalee Najar Individual Corporate Director Jun 29, 2017
Fidel Atkinson Individual Corporate Director Jun 28, 2016
Elena L Marin Individual Corporate OfficerChief Executive Officer Jul 2, 2003
W-2 Managing Employee Jul 2, 2003
Operational/Managerial ControlChief Executive Officer Jul 2, 2003
Aida Cantu Individual Corporate Director Jun 28, 2018

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Su Clinica FamiliarSanta Rosa, TX, CCN 671951 Federally qualified health center Operational/Managerial Control Jul 1, 2010

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1427071968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 TREASURE HILLS BLVD",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785508911",
            "telephone_number": "956-365-6750",
            "fax_number": "956-365-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 TREASURE HILLS BLVD",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785508911",
            "telephone_number": "956-365-6750",
            "fax_number": "956-365-6779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SU CLINICA FAMILIAR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "SALDIVAR",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "956-365-6750",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019025801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WOMENS HEALTH CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Harlingen, TX

Sources for this page

Verify at the official NPI Registry.