NPIMap

Organization Active NPI

Ector County Hospital District

Doing business as MCH Family Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Odessa, TX
National Provider Identifier
1558715201
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ECTOR COUNTY HOSPITAL DISTRICT
Doing business as
MCH Family Health Clinic
Practice address
6030 W University Blvd
Odessa, TX 79764-8530
Phone
(432) 640-6600
Fax
(432) 640-4791
NPI assigned
Apr 19, 2016
Last updated
Oct 8, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ECTOR COUNTY HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Authorized official

Name
David Garcia
Title
Executive Director
Phone
(432) 640-4868

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Family Medicine Physician 207Q00000X NU

Addresses

Primary practice location

6030 W University Blvd
Odessa, TX 79764-8530

Mailing address

6030 W University Blvd Ste 100
Odessa, TX 79764-8530
Phone (432) 640-6600

Other names 1

  • MCH Family Health Clinic Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040412001222 TX Part B Supplier - Clinic/Group Practice 5496657769 Receives reassigned benefits from 49 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Odessa, TX
O20160927001365 TX Part A Provider - Federally Qualified Health Center (FQHC) 5496657769 Practice locations: Odessa, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1558715201. Details of each certification follow.

Federally qualified health center certification: CCN 741933

Legal name
ECTOR COUNTY HOSPITAL DISTRICT
Doing business as
FAMILY HEALTH CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 22, 2016
Last certification
Sep 22, 2016
Ownership / control type
For profit – corporation
Organization structure
GovernmentNon-profit
Enrollment address
6030 W University Blvd
Odessa, TX 79764-8530

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Medical Center Hospital ER9 organizations share this tax ID, including this one
Part of
Medical Center Hospital ER

Other organizations with this tax ID 8

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

Locations

6030 W University Blvd
Ste 100
Odessa, TX 79764

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Debby Mireles Individual W-2 Managing EmployeeProvider Relations Director Jan 13, 2010
Ector County Hospital District Organization, Odessa, TX Non-profit 5% Or Greater Direct Ownership Interest Oct 1, 2014 100%
David Garcia Individual 5% Or Greater Indirect Ownership InterestExecutive Director Oct 1, 2014
Corporate DirectorExecutive Director Oct 18, 2014

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Medical Center HospitalOdessa, TX, CCN 450132 Hospital 5% Or Greater Direct Ownership Interest Jan 1, 1975
Encompass Health Rehabilitation Hospital of Midland OdessaMidland, TX, CCN 453057 Hospital 5% Or Greater Indirect Ownership Interest (17%) Jul 1, 2021
Family Health ClinicOdessa, TX, CCN 671912 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2006
MCH Family Health ClinicOdessa, TX, CCN 451162 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2021
MCH Family Health ClinicOdessa, TX, CCN 671081 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2023

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728345600000",
    "number": "1558715201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6030 W UNIVERSITY BLVD STE 100",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797648530",
            "telephone_number": "432-640-6600",
            "fax_number": "432-640-4776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6030 W UNIVERSITY BLVD",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797648530",
            "telephone_number": "432-640-6600",
            "fax_number": "432-640-4791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECTOR COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ECTOR COUNTY HOSPITAL DISTRICT",
        "enumeration_date": "2016-04-19",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "432-640-4868"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCH Family Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.