Frontera Healthcare Network
Organization Active NPI Federally Qualified Health Center (FQHC) · Menard, TX
NPI 1447594247 · NPPES record last updated Feb 28, 2023
Key facts
- NPI
- 1447594247
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- FRONTERA HEALTHCARE NETWORK
- Practice address
- 119 S. Ellis St
Menard, TX 76859-0889 - Phone
- (325) 396-4733
- Fax
- (325) 396-2055
- NPI assigned
- Nov 16, 2012
- Organization subpart
- No
Authorized official
- Name
- Mikki Hand
- Title
- Executive Director
- Phone
- (325) 869-5500
Owners & managing parties with NPI records 1
-
Mikki Hand, APRN, FNP-C
Owned or controlled facilities with NPI records 3
Other NPIs on the same Medicare enrollment 8
Other NPIs with the same Medicare PAC ID 6
Corporate family (same tax ID) 5
Practitioners 12
-
Karla Moerbe, LPC
-
Ruby Compton, FNP-C
-
Cameron B Culver, M.D.
-
John Paul Guerrero, LPC
-
Danna Schaeffer Harrison, MA, LPC
-
Pauline Velez, LCSW
-
Maryanne Fisher, FNP-C
-
Eileen Ann Tomasiak, PA-C
-
Kathy Seekatz, APRN, FNP-C, FNP-BC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D0675269 | Frontera Healthcare Network Mendard Clinic | Certificate of waiver | Sep 10, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX
Federally qualified health center certification: CCN 671865
- Legal name
- FRONTERA HEALTHCARE NETWORK
- Doing business as
- FRONTERA HEALTHCARE NETWORK MENARD CLINIC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Nov 28, 2007
- Last certification
- Nov 28, 2007
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Nov 29, 2005 in TX
- Enrollment address
- 119 S Ellis
Menard, TX 76859
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Dudley R White |
Corporate Director |
Jul 1, 2007 | |
| Misty B Standard |
Corporate Director |
Aug 25, 2020 | |
| Lisa Heath |
Corporate Director |
Sep 27, 2018 | |
| Jay N Cunningham |
Corporate Director |
Feb 25, 2020 | |
| James Ed Savage |
Corporate Director |
Nov 19, 2012 | |
| Kristi Saiz |
W-2 Managing Employee |
Nov 1, 2022 | |
| Tony Sosa |
Corporate Director |
May 26, 2020 | |
| Barbara K Stansberry |
Corporate Director |
Jul 16, 2007 | |
| Mikki Hand |
Corporate Officer |
Aug 21, 2022 | |
| Corporate Director |
Aug 21, 2022 | ||
| Gloria Abilez |
Corporate Director |
Jan 22, 2018 |
All facility ownership & control disclosures 3
| Facility | Type | Role | Since |
|---|---|---|---|
| Frontera Healthcare Network |
Federally qualified health center | 5% Or Greater Direct Ownership Interest Operational/Managerial Control |
Feb 11, 2000 Feb 11, 2000 |
| Frontera Healthcare Network |
Federally qualified health center | 5% Or Greater Direct Ownership Interest Operational/Managerial Control |
Feb 11, 2000 Feb 11, 2000 |
| Frontera Healthcare Network |
Federally qualified health center | 5% Or Greater Direct Ownership Interest Operational/Managerial Control |
Feb 11, 2000 Feb 11, 2000 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071008000127 | TX | Part a Provider - Federally Qualified Health Center (FQHC) | 8426142522 |
1 other NPI on this enrollment Practice locations: Menard, TX |
| O20160907002398 | TX | Part B Supplier - Clinic/Group Practice | 8426142522 |
Receives reassigned benefits from 28 practitioners 8 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Menard, TX; Brady, TX; Mason, TX; Junction, TX; Fredericksburg, TX |
National Provider Directory
- Tax ID family
- Frontera Healthcare Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
119 S. Ellis St
Menard, TX 76859-0889
Mailing address
PO Box 989
Eden, TX 76837-0989
Phone (325) 869-5500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 188389402 | Medicaid | TX |
Other names
- Frontera Healthcare Network - Menard Medical
Other providers in Menard, TX
- Bronte Isd
- Concho County Hospital
- Crockett County Cisd
- Frontera Healthcare Network, Inc.
- Barbara Hooten
- Justin Brad Loftin
- Menard County Hospital District
- Menard Emergency Services, Inc.
All providers in Menard, 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 Feb 28, 2023. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.