Brazos Valley Community Action Agency, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Caldwell, TX
NPI 1609150465 · NPPES record last updated Sep 11, 2024
Key facts
- NPI
- 1609150465
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.
- Practice address
- 1103 Woodson Dr
Caldwell, TX 77836-1052 - Phone
- (979) 567-7080
- Fax
- (979) 567-9783
- NPI assigned
- Sep 28, 2011
- Organization subpart
- Yes
- Parent organization (as reported)
- BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.
Authorized official
- Name
- Theresa Sabella, JD, PHD
- Title
- Ceo
- Phone
- (979) 383-2348
Owners & managing parties with NPI records 1
-
Maryann Miyun Choi I, M.D.
Other NPIs on the same Medicare enrollment 14
Other NPIs with the same Medicare PAC ID 14
Corporate family (same tax ID) 18
Practitioners 51
-
Roland R Garza, MD
-
Kimberly Allison Glidewell, M.S., PA-C
-
Kia E Parsi, M.D.
-
Daniel Lawrence Quan, D.O.
-
Michele Armstrong, WHNP
-
Shirley Jeanne Baker, PA-C
-
Neile Elaine Briden, APRN, FNP-C
-
Brenda Kay Clarke, FNP-C
-
Michelle Linda Eppers, RN WHNP-BC
-
Shelly Dawn Hitchcock, FNP-C
-
Jerry Don Lloyd, FNP-C
-
Crystal James Mable, FNP
-
Nyasha Manyame, ARNP
-
Kimberly McBride, FNP-BC
-
Blake Kent McDaniel, FNP-C
-
Lawrence Quan, MD
-
Jeflyn D Tate, WHNP
-
Miranda L Allen, LCSWS
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX
Federally qualified health center certification: CCN 671973
- Legal name
- BRAZOS VALLEY COMMUNITY ACTION AGENCY INC
- Doing business as
- HEALTHPOINT
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Dec 16, 2011
- Last certification
- Dec 16, 2011
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jul 15, 1988 in TX
- Enrollment address
- 1103 Woodson Dr
Caldwell, TX 77836-1052
All disclosed owners & managing parties 17
| Name | Role | Since | Share |
|---|---|---|---|
| Jennifer Mertz |
Corporate Officer |
Jul 15, 2019 | 12% |
| Maryann Miyun Choi |
Corporate Officer |
Feb 5, 2024 | 12% |
| Mike Sutherland |
Corporate Director |
Aug 12, 2010 | |
| Debra Makowsky |
Corporate Officer |
Feb 5, 2024 | 12% |
| W-2 Managing Employee |
Feb 5, 2024 | ||
| William Rios |
Corporate Director |
Jun 1, 2021 | |
| Mathew Woods |
Corporate Director |
Jun 1, 2021 | |
| Jacqueln Morrow |
Corporate Director |
Jun 1, 2021 | |
| Janie O Velasquez |
Corporate Director |
Apr 11, 2014 | |
| James McCullough |
Corporate Director |
May 10, 2012 | |
| Tasha de la Torre |
Corporate Director |
Jun 1, 2024 | |
| Carolyn Konecny |
Corporate Officer |
Aug 19, 2024 | 15% |
| Kimberley Usher |
Corporate Director |
Sep 13, 2017 | |
| Brian Thurston |
Corporate Officer |
Feb 1, 2024 | 12% |
| Lucina Monarrez |
Corporate Director |
Mar 18, 2026 | |
| Mary Wauters |
Corporate Officer |
Apr 4, 2022 | 25% |
| W-2 Managing Employee | Apr 1, 2026 | ||
| Laquita Clewis |
Corporate Director |
Sep 13, 2017 | |
| Yoexys Truxillo |
Corporate Officer |
May 4, 2026 | 12% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040708001095 | TX | Part B Supplier - Clinic/Group Practice | 4284542127 |
Receives reassigned benefits from 61 practitioners 14 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Trinity, TX; Rockdale, TX; Navasota, TX; Madisonville, TX; Hempstead, TX; Hearne, TX; College Station, TX; Centerville, TX… |
| O20111123000318 | TX | Part a Provider - Federally Qualified Health Center (FQHC) | 4284542127 | Practice locations: Caldwell, TX |
National Provider Directory
- Tax ID family
- Brazos Valley Community
- Part of
- Brazos Valley Community
Locations
1301 Memorial Dr
Bryan, TX 77802
Phone (979) 731-4520
Interoperability endpoints
- kparsi@caldwellhltpt.direct.st-joseph.md
- kleubner@caldwellhltpt.direct.st-joseph.md
- kglidewell@caldwellhltpt.direct.st-joseph.md
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
1103 Woodson Dr
Caldwell, TX 77836-1052
Mailing address
1500 University Dr E
Suite 100
College Station, TX 77840-2600
Phone (979) 846-1100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 287952001 | Medicaid | TX |
Other names
- HealthPoint
- HealthPoint Caldwell
Other providers in Caldwell, TX
- Sandra Blasig
- Jaa'Lah B Bowser
- Brazos Valley Community Action Agency, Inc.
- Brazos Valley Community Action Agency, Inc.
- Brazos Valley Community Action Agency, Inc.
- Brookshire Brothers Inc
- Burleson County Family Medicine PLLC
- Burleson County Hospital District
- Burleson Lease Corp
- Burleson St. Joseph Health Center of Caldwell, Texas
All providers in Caldwell, TX · Federally Qualified Health Center (FQHC) in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.