NPIMap

Organization Active NPI

Matagorda Episcopal Health Outreach Program

  • Federally Qualified Health Center (FQHC)
  • Palacios, TX
National Provider Identifier
1467009092
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MATAGORDA EPISCOPAL HEALTH OUTREACH PROGRAM
Practice address
307 Green Ave Ste a
Palacios, TX 77465-3213
Phone
(979) 245-2008
NPI assigned
Aug 19, 2019
Last updated
Jun 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

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

Authorized official

Name
Celeste Harrison
Title
Ceo
Phone
(979) 245-2008

Specialties & licenses 1

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

Addresses

Primary practice location

307 Green Ave Ste a
Palacios, TX 77465-3213

Mailing address

101 Avenue F N
Bay City, TX 77414-3167
Phone (979) 245-2008

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191031000777 TX Part A Provider - Federally Qualified Health Center (FQHC) 6002853538 Practice locations: Palacios, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467009092. Details of each certification follow.

Federally qualified health center certification: CCN 451092

Legal name
MATAGORDA EPISCOPAL HEALTH OUTREACH PROGRAM CORPORATION
Doing business as
VIBRANCE HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 1, 2019
Last certification
Nov 1, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 15, 2006 in TX
Enrollment address
307 Green Ave
Ste a
Palacios, TX 77465-3213

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Matagorda Episcopal Health Outreach Program Corporation12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Tisha Zalman Individual Corporate OfficerCfo Jul 1, 2021
W-2 Managing EmployeeCfo Jul 1, 2021
Nan Harrison Individual Corporate OfficerCeo Jul 13, 2008 100%
W-2 Managing EmployeeCeo Jul 13, 2008

Practitioners & affiliated clinicians

Practitioners 51

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.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749168000000",
    "number": "1467009092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 AVENUE F N",
            "city": "BAY CITY",
            "state": "TX",
            "postal_code": "774143167",
            "telephone_number": "979-245-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 GREEN AVE STE A",
            "city": "PALACIOS",
            "state": "TX",
            "postal_code": "774653213",
            "telephone_number": "979-245-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATAGORDA EPISCOPAL HEALTH OUTREACH PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-19",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "CELESTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "979-245-2008"
    },
    "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 Palacios, TX

Sources for this page

Verify at the official NPI Registry.