NPIMap

Organization Active NPI

El Centro del Barrio Inc

  • Federally Qualified Health Center (FQHC)
  • San Antonio, TX
National Provider Identifier
1497935233
Registry record updated Jun 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
HBOCS007758-04-00 Issued in TX
Legal business name
EL CENTRO DEL BARRIO INC
Practice address
910 Wagner Ave
San Antonio, TX 78211-3213
Phone
(210) 924-7344
Fax
(210) 923-7929
NPI assigned
Nov 9, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Chuck Walzel
Title
Cfo
Phone
(210) 334-3724

Practitioners 21

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

View all 21

National Provider Directory

National Provider Directory
Tax ID family
El Centro del Barrio in37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

View all 36

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X HBOCS00758-04-00 TX
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X HBOCS00758-04-00 TX
Federally Qualified Health Center (FQHC) 261QF0400X HBOCS007758-04-00 TX Primary

Addresses

NPPES NPI Registry

Primary practice location

910 Wagner Ave
San Antonio, TX 78211-3213

Mailing address

3750 Commercial Ave
San Antonio, TX 78221-3117
Phone (210) 334-3700

Other identifiers 6

NPPES NPI Registry
IdentifierTypeStateIssuer
120980103MedicaidTX
00MT08OtherTXGROUP MEDICARE
120980102MedicaidTX
102980101MedicaidTX
G60232-02OtherTXDELTA DENTAL
120980105MedicaidTX

Other names 1

NPPES NPI Registry
  • CentroMed South Park Dental Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 1, 2012.

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338508800000",
    "number": "1497935233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 COMMERCIAL AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782213117",
            "telephone_number": "210-334-3700",
            "fax_number": "210-922-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 WAGNER AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782113213",
            "telephone_number": "210-924-7344",
            "fax_number": "210-923-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL CENTRO DEL BARRIO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2012-06-01",
        "status": "A",
        "authorized_official_last_name": "WALZEL",
        "authorized_official_first_name": "CHUCK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "210-334-3724"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "HBOCS00758-04-00",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "HBOCS00758-04-00",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "TX",
            "license": "HBOCS007758-04-00",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120980103",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "00MT08",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120980102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102980101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "G60232-02",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120980105",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CentroMed South Park Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.