El Centro del Barrio, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

HBOCS00758-04-00 Issued in TX

Legal business name

EL CENTRO DEL BARRIO, INC.

Doing business as

CentroMed Santa Rosa Clinic/Ryan White Clinic
CentroMed Santa RosaClinic/Ryran White Clinic

Practice address

315 N San Saba
Suite # 103
San Antonio, TX 78207-3154

Phone

(210) 922-7000

Fax

(210) 924-1374

NPI assigned

Nov 24, 2006

Organization subpart

No

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

Authorized official

Name

Chuck Walzel

Title

VP/Cfo

Phone

(210) 334-3724

Specialties & licenses 2

Addresses

Other identifiers 5

Other names 2

• CentroMed Santa Rosa Clinic/Ryan White Clinic Doing business as
• CentroMed Santa RosaClinic/Ryran White Clinic Doing business as

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571961600000",
    "number": "1699841569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 COMMERCIAL AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782213117",
            "telephone_number": "210-334-3700",
            "fax_number": "210-922-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N SAN SABA",
            "address_2": "SUITE # 103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073154",
            "telephone_number": "210-922-7000",
            "fax_number": "210-924-1374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL CENTRO DEL BARRIO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2019-10-25",
        "status": "A",
        "authorized_official_last_name": "WALZEL",
        "authorized_official_first_name": "CHUCK",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "210-334-3724"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "HBOCS00758-04-00",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "TX",
            "license": "HBOCS00758-04-00",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120980101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120980102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120980105",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "00MT08",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120980103",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CentroMed Santa Rosa Clinic/Ryan White Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CentroMed Santa RosaClinic/Ryran White Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• El Centro del Barrio, Inc. (CentroMed South Park Medical Clinic)
• El Centro del Barrio, Inc. (CentroMed SA Pediatrics)
• El Centro del Barrio, Inc. (CentroMed Women's Health Clinic)
• El Centro del Barrio, Inc. (CentroMed La Paloma de Paz)
• El Centro del Barrio, Inc. (CentroMed Pharmacy- Walzem)
• El Centro del Barrio, Inc. (University Family Health Center-SE)
• El Centro del Barrio, Inc. (CentroMed SA Pediatrics)
• El Centro del Barrio, Inc. (Palo Alto Clinic)
• El Centro del Barrio, Inc. (CentroMed Walzem Clinic)
• El Centro del Barrio, Inc. (CentroMed South Park Dental)

• Federally Qualified Health Center (FQHC) in San Antonio, TX
• Providers in San Antonio, 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 Oct 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.