NPIMap

Organization Active NPI

United Medical Centers

  • Federally Qualified Health Center (FQHC)
  • Del Rio, TX
National Provider Identifier
1629320221
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
UNITED MEDICAL CENTERS
Practice address
1117 W de la Rosa St
Del Rio, TX 78840-6224
Phone
(830) 768-4800
Fax
(830) 768-4844
NPI assigned
Oct 5, 2012
Last updated
Apr 15, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
UNITED MEDICAL CENTERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Authorized official

Name
William Worrell
Title
Ceo
Phone
(830) 773-8917

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X TX Primary
Physician Assistant 363A00000X
Family Nurse Practitioner 363LF0000X TX
Pediatric Nurse Practitioner 363LP0200X
Women's Health Nurse Practitioner 363LW0102X
Mental Health Counselor 101YM0800X
General Practice Dentistry 1223G0001X TX
Dental Hygienist 124Q00000X
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X
Interventional Cardiology Physician 207RI0011X
Obstetrics & Gynecology Physician 207V00000X TX
Pediatrics Physician 208000000X TX
General Practice Physician 208D00000X
Podiatrist 213E00000X

Addresses

Primary practice location

1117 W de la Rosa St
Del Rio, TX 78840-6224

Mailing address

PO Box 1470
Eagle Pass, TX 78853-1470
Phone (830) 773-8917

Other identifiers 2

IdentifierTypeStateIssuer
137809302MedicaidTX
137809313 (FQHC SITEMedicaidTX

Other names 1

  • SAN FELIPE CLINIC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140602000691 TX Part A Provider - Federally Qualified Health Center (FQHC) 7618957135 Practice locations: Del Rio, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629320221. Details of each certification follow.

Federally qualified health center certification: CCN 451928

Legal name
UNITED MEDICAL CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 5, 2000
Last certification
Sep 5, 2000
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jul 24, 1978 in TX
Enrollment address
1117 W de la Rosa St
Del Rio, TX 78840-6224
Related CCNs
451853

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 10

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

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
45D0976501United Medical Centers Dba San Felipe1117 West de la Rosa St, Del Rio, TX 78840AccreditationNov 19, 2027

National Provider Directory

National Provider Directory
Tax ID family
United Medical Cntrs10 organizations share this tax ID, including this one
Part of
United Medical Cntrs

Other organizations with this tax ID 9

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

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Alma Gonzalez Individual W-2 Managing EmployeeHealthcare Systems Compliance Co Sep 27, 2013
Mario Pola Individual Corporate OfficerGrant Administrator/Asst Admin Aug 5, 1987 100%
Operational/Managerial ControlGrant Administrator Aug 5, 1987 100%
Lydia T Olvera Individual W-2 Managing EmployeeClinic Manager Nov 17, 2017
Rafael E Olvera Individual Corporate OfficerChief Financial Officer Jun 18, 2010 100%
Operational/Managerial ControlChief Financial Officer Jun 18, 2010

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776211200000",
    "number": "1629320221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1470",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788531470",
            "telephone_number": "830-773-8917",
            "fax_number": "830-773-1892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 W DE LA ROSA ST",
            "city": "DEL RIO",
            "state": "TX",
            "postal_code": "788406224",
            "telephone_number": "830-768-4800",
            "fax_number": "830-768-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED MEDICAL CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNITED MEDICAL CENTERS",
        "enumeration_date": "2012-10-05",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A",
        "authorized_official_last_name": "WORRELL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "830-773-8917"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137809302",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137809313 (FQHC SITE",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAN FELIPE CLINIC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SAN FELIPE CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Del Rio, TX

Sources for this page

Verify at the official NPI Registry.