Community Health Centers of South Central Texas, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.

Doing business as

Women's Health and WIC Center

Practice address

229 St. George Street
Gonzales, TX 78629-3910

Phone

(830) 672-6511

Fax

(830) 672-3981

NPI assigned

Jan 7, 2011

Last updated

Jan 12, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.As reported in NPPES

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

Authorized official

Name

Mr. Henry F Salas

Title

Chief Executive Officer

Phone

(830) 672-6511

Specialties & licenses 1

Addresses

Other names 1

• Women's Health and WIC Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467756247. Details of each certification follow.

• CCN 671965 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 671965

Legal name

WOMEN'S HEALTH AND WIC CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Apr 19, 2011

Last certification

Apr 19, 2011

Ownership / control type

For profit – corporation

Facility address

229 St George Street
Gonzales, TX 78629

Other NPIs on the same Medicare enrollment 1

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

• Community Health Centers of South Central Texas, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gonzales, TX
  • NPI 1285650424

  O20040624001546

  Same enrollment

Part of

Community Health Centers of

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.

• Roland A Medellin, M.D.

  • Family Medicine Physician
  • Gonzales, TX
  • NPI 1184626871
  NPD

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

{
    "created_epoch": "1294358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294790400000",
    "number": "1467756247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1890",
            "city": "GONZALES",
            "state": "TX",
            "postal_code": "786291390",
            "telephone_number": "830-672-6511",
            "fax_number": "512-291-5657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 ST. GEORGE STREET",
            "city": "GONZALES",
            "state": "TX",
            "postal_code": "786293910",
            "telephone_number": "830-672-6511",
            "fax_number": "830-672-3981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.",
        "enumeration_date": "2011-01-07",
        "last_updated": "2011-01-12",
        "status": "A",
        "authorized_official_last_name": "SALAS",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "830-672-6511",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Women's Health and WIC Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Children's Dentistry of Kyle (Children's Dentistry of Gonzales)
• Terry Matthew Clay
• Charlene Ann Cockcroft
• William Frnak Cole, M.D.
• Community Health Centers of South Central Texas, Inc.
• Christina M Cordova, LVN
• Country Clinic PLLC
• Craig Cardiovascular Center, PA
• William E Craig, MD
• Todd Michael Crawford, PHYSICIAN ASST - C

• Federally Qualified Health Center (FQHC) in Gonzales, TX
• Providers in Gonzales, TX by specialty
• Federally Qualified Health Center (FQHC) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.