Legacy Community Health Services, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

LEGACY COMMUNITY HEALTH SERVICES, INC

Practice address

9606 Mesa Dr
Houston, TX 77078-3024

Phone

(832) 548-5000

Fax

(832) 548-5469

NPI assigned

Oct 5, 2012

Organization subpart

No

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

Authorized official

Name

Robert Peter Palussek

Title

Coo

Phone

(832) 548-5000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

Federally qualified health center certification: CCN 741825

Legal name

LEGACY COMMUNITY HEALTH SERVICES, INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

May 23, 2013

Last certification

May 23, 2013

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Jan 25, 1982 in TX

Enrollment address

9606 Mesa Dr
Houston, TX 77078-3024

Federally qualified health center certification: CCN 741819

Legal name

LEGACY COMMUNITY HEALTH SERVICES, INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jun 24, 2013

Last certification

Jun 24, 2013

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Jan 25, 1982 in TX

Enrollment address

5420 Dashwood Dr
Ste 100
Houston, TX 77081-5333

Other NPIs on the same Medicare enrollment 1

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

• Legacy Community Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Houston, TX
  • NPI 1538414214

  O20130624000489

  Same enrollment

Locations

All disclosed owners & managing parties 14

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

Owners & managing parties with NPI records 1

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

• Allison Floyd Wells, M.D.

  • Anesthesiology Physician
  • Spring, TX
  • NPI 1528268117

  Corporate Director

  CMS ownership

All facility ownership & control disclosures 21

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

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

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1598017261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66308",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77266",
            "telephone_number": "832-548-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9606 MESA DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770783024",
            "telephone_number": "832-548-5000",
            "fax_number": "832-548-5469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY COMMUNITY HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-05",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A",
        "authorized_official_last_name": "PALUSSEK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "832-548-5000"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Legacy Community Health Services, Inc
• Legacy Community Health Services, Inc
• Legacy Community Health Services, Inc
• Legacy Community Health Services, Inc
• Legacy Community Health Services, Inc
• Legacy Community Health Services, Inc
• Legacy Community Health Services, Inc
• Legacy Community Health Services, Inc
• Legacy Community Health Services, Inc
• Legacy Community Health Services, Inc

• Federally Qualified Health Center (FQHC) in Houston, TX
• Providers in Houston, 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 9, 2025; 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.