NPIMap

Organization Active NPI

Atascosa Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Three Rivers, TX
National Provider Identifier
1629844667
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ATASCOSA HEALTH CENTER, INC.
Practice address
300 E Martin St
Three Rivers, TX 78071
Phone
(361) 786-3618
Fax
(361) 786-3649
NPI assigned
Nov 30, 2023
Organization subpart
Yes
Parent organization
ATASCOSA HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Authorized official

Name
Mr. Monty Small
Title
Ceo
Phone
(830) 569-8940

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

300 E Martin St
Three Rivers, TX 78071

Mailing address

310 W Oaklawn Rd
Pleasanton, TX 78064-4033
Phone (830) 569-8940

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040420001663 TX Part B Supplier - Clinic/Group Practice 3779579412 Receives reassigned benefits from 25 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Poteet, TX; Three Rivers, TX; Tilden, TX; Lytle, TX; Karnes City, TX; Floresville, TX; Pleasanton, TX
O20240215000688 TX Part A Provider - Federally Qualified Health Center (FQHC) 3779579412 Practice locations: Three Rivers, TX

Federally qualified health center certification: CCN 741139

Legal name
ATASCOSA HEALTH CENTER, INC.
Doing business as
LIVE OAK COMMUNITY CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 11, 2024
Last certification
Mar 11, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 7, 1979 in TX
Enrollment address
300 E Martin St
Three Rivers, TX 78071

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 7

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

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
45D2297742Atascosa Health Center, Inc300 E Martin St, Three Rivers, TX 78071Certificate of waiverJan 21, 2028

National Provider Directory

National Provider Directory
Tax ID family
Atascosa Health Center8 organizations share this tax ID, including this one
Part of
Atascosa Health Center

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Maria D Cruz Individual Corporate OfficerBoard Member Jul 27, 2023
Virginia Herring Individual Corporate OfficerBoard Member Jul 27, 2017
Gloria Sosa Individual Corporate OfficerBoard Member Jul 27, 2023
Lillian R Cashmer Individual Corporate OfficerBoard Member Oct 3, 2008
Kara Luna Individual Corporate OfficerBoard Member Sep 28, 2017
Clinton McDougal Individual Corporate OfficerBoard Member Jul 27, 2023
Carlos Vidal Munoz Individual Corporate OfficerBoard Member Sep 28, 2017
Monty B Small Individual Corporate OfficerChief Executive Officer Sep 1, 2004
W-2 Managing EmployeeChief Executive Officer Sep 1, 2004
Lillian W Lyssey Individual Corporate OfficerBoard Member Oct 1, 2008
James Teal Individual Corporate OfficerBoard Member Apr 28, 2016
Bessilia Guerrero Individual Corporate OfficerBoard Member Oct 26, 2023
Dwayne Villanueva Individual Corporate OfficerBoard Member Jan 5, 2010
Tammy H Favor Individual Corporate OfficerBoard Member Mar 28, 2013
Henry Salas Individual Corporate OfficerBoard Member Sep 28, 2017
Maria Garcia Individual Corporate OfficerChief Financial Officer Feb 1, 2005
Rosario C Oropeza Individual Corporate OfficerBoard Member May 13, 2021

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.

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775779200000",
    "number": "1629844667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 W OAKLAWN RD",
            "city": "PLEASANTON",
            "state": "TX",
            "postal_code": "780644033",
            "telephone_number": "830-569-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E MARTIN ST",
            "city": "THREE RIVERS",
            "state": "TX",
            "postal_code": "78071",
            "telephone_number": "361-786-3618",
            "fax_number": "361-786-3649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATASCOSA HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATASCOSA HEALTH CENTER, INC.",
        "enumeration_date": "2023-11-30",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A",
        "authorized_official_last_name": "SMALL",
        "authorized_official_first_name": "MONTY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "830-569-8940",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Three Rivers, TX

Sources for this page

Verify at the official NPI Registry.