NPIMap

Organization Active NPI

Houston Area Community Services Inc.

Doing business as Avenue 360 Health and Wellness Fannin

  • Federally Qualified Health Center (FQHC)
  • Houston, TX
National Provider Identifier
1639752124
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HOUSTON AREA COMMUNITY SERVICES INC.
Doing business as
Avenue 360 Health and Wellness Fannin
Practice address
2920 Fannin St
Houston, TX 77002
Phone
(713) 341-3790
NPI assigned
May 3, 2021
Last updated
Jun 12, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
HOUSTON AREA COMMUNITY SERVICES INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Authorized official

Name
Tequila Henderson
Title
Revenue Cycle Director
Phone
(713) 426-0027

Specialties & licenses 1

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

Addresses

Primary practice location

2920 Fannin St
Houston, TX 77002

Mailing address

2150 W 18TH St Ste 300
Houston, TX 77008-1289
Phone (713) 426-0027

Other names 1

  • Avenue 360 Health and Wellness Fannin Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071115000320 TX Part B Supplier - Clinic/Group Practice 6608977095 Receives reassigned benefits from 41 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Humble, TX; Houston, TX
O20210930000962 TX Part A Provider - Federally Qualified Health Center (FQHC) 6608977095 Practice locations: Houston, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639752124. Details of each certification follow.

Federally qualified health center certification: CCN 451159

Legal name
HOUSTON AREA COMMUNITY SERVICES, INC.
Doing business as
AVENUE 360 HEALTH AND WELLNESS MIDTOWN
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 18, 2021
Last certification
Oct 18, 2021
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Jul 1, 1998 in TX
Enrollment address
2920 Fannin St
Houston, TX 77002-9222

Other NPIs with the same Medicare PAC ID 5

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.

National Provider Directory

National Provider Directory
Tax ID family
Houston Area Comm SVC Inc7 organizations share this tax ID, including this one
Part of
Houston Area Comm SVC Inc

Other organizations with this tax ID 6

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

Locations

18842 S Memorial Dr
Ste 206
Humble, TX 77338
Phone (281) 446-1014

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Tequila Henderson Individual Corporate DirectorRevenue Cycle Manager Jan 31, 2024
W-2 Managing EmployeeAd; Jan 31, 2024
Houston Area Community Services, Inc. Organization, Houston, TX For-profit Operational/Managerial Control Mar 1, 2021

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Avenue 360 Health and WellnessHouston, TX, CCN 671910 Federally qualified health center Other Sep 1, 2023
Avenue 360 Health and Wellness - Spring CypressHouston, TX, CCN 741872 Federally qualified health center Operational/Managerial Control (100%) Apr 1, 2014

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781222400000",
    "number": "1639752124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 W 18TH ST STE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770081289",
            "telephone_number": "713-426-0027",
            "fax_number": "832-209-7186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77002",
            "telephone_number": "713-341-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSTON AREA COMMUNITY SERVICES INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOUSTON AREA COMMUNITY SERVICES INC.",
        "enumeration_date": "2021-05-03",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "TEQUILA",
        "authorized_official_title_or_position": "REVENUE CYCLE DIRECTOR",
        "authorized_official_telephone_number": "713-426-0027"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avenue 360 Health and Wellness Fannin",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avenue 360 Health and Wellness Fannin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.