NPIMap

Organization Active NPI

La Esperanza Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Angelo, TX
National Provider Identifier
1487424602
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LA ESPERANZA CLINIC, INC.
Practice address
34 Buick St
San Angelo, TX 76901-4730
Phone
(325) 658-5399
NPI assigned
Jan 8, 2024
Organization subpart
Yes
Parent organization
LA ESPERANZA CLINIC, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Authorized official

Name
Rosie Castaneda
Title
Cfo
Phone
(325) 947-5623

Specialties & licenses 1

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

Addresses

Primary practice location

34 Buick St
San Angelo, TX 76901-4730

Mailing address

2029 W Beauregard Ave
San Angelo, TX 76901-3812
Phone (325) 658-5339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040415000585 TX Part B Supplier - Clinic/Group Practice 7416942933 Receives reassigned benefits from 26 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Angelo, TX
O20240417002893 TX Part A Provider - Federally Qualified Health Center (FQHC) 7416942933 Practice locations: San Angelo, TX

Federally qualified health center certification: CCN 741147

Legal name
LA ESPERANZA CLINIC INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 1, 2024
Last certification
Apr 1, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
34 Buick St
San Angelo, TX 76901-4730

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 3

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2308047La Esperanza Clinic West34 Buick St, San Angelo, TX 76901Certificate of waiverJul 18, 2028

National Provider Directory

National Provider Directory
Tax ID family
La Esperanza Clinic Inc3 organizations share this tax ID, including this one
Part of
La Esperanza Clinic Inc

Other organizations with this tax ID 2

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

Locations

1600 Volney St
San Angelo, TX 76903
Phone (915) 486-1303

2033 W Beauregard Ave
San Angelo, TX 76901
Phone (325) 944-8900

35 E 31st St
Ste B
San Angelo, TX 76903
Phone (325) 223-8129

35 E 31st St
Ste 1
San Angelo, TX 76903

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
David Vessell Individual Corporate DirectorBoard Vice-Chairperson Jan 1, 2024
Rosa Castaneda Individual Corporate OfficerCfo May 13, 2013
W-2 Managing EmployeeCfo May 13, 2013
Monica Navarro Individual Corporate DirectorBoard Secretary Jan 1, 2024
Fonda V Galindo Individual Corporate DirectorBoard Treasurer Jan 1, 2024
Quinda Feil-Duncan Individual Corporate DirectorBoard Chairperson Jan 1, 2024
Dean Munn Individual Corporate OfficerCeo Feb 4, 2019
W-2 Managing EmployeeCeo Feb 4, 2019

Practitioners & affiliated clinicians

Practitioners 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704672000000",
    "number": "1487424602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2029 W BEAUREGARD AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769013812",
            "telephone_number": "325-658-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 BUICK ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769014730",
            "telephone_number": "325-658-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA ESPERANZA CLINIC, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LA ESPERANZA CLINIC, INC.",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A",
        "authorized_official_last_name": "CASTANEDA",
        "authorized_official_first_name": "ROSIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "325-947-5623"
    },
    "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 San Angelo, TX

Sources for this page

Verify at the official NPI Registry.