El Centro del Barrio, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Somerset, TX
NPI 1811061872 · NPPES record last updated Oct 25, 2019
Key facts
- NPI
- 1811061872
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- License
- HBOCS00758-04-00 (TX)
- Legal business name
- EL CENTRO DEL BARRIO, INC.
- Practice address
- 7315 S. Loop 1604 West
Somerset, TX 78069 - Phone
- (210) 922-7000
- Fax
- (210) 924-1374
- NPI assigned
- Nov 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Chuck Walzel
- Title
- VP/Cfo
- Phone
- (210) 334-3724
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 20
Corporate family (same tax ID) 36
Related certifications (CCN) 1
Practitioners 21
-
Aysun Alagoz, M.D.
-
Juan E Carballo, M.D
-
Rosa Luinda Combs, LCSW
-
Hanaa Girgis, M.D.
-
Herbert Guzman-Cruz, M.D.
-
Lisa Rose Huizar, LCSW
-
Rosalio Jalomo, MD
-
Spencer Ryan Lewis, M.D.
-
Carlos E Licon, M.D.
-
Rafael Martinez, M.D.
-
Nonyerem N Osuji, MD
-
Ernesto Parra, M.D.
-
Norma Parra, M.D.
-
Adriana Uribe, D.P.M.
-
Sylvia Allen, FNP-BC
-
Vicente Canales, DDS
-
Lorena Guerrero, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Federally qualified health center certification: CCN 671804
- Legal name
- EL CENTRO DEL BARRIO INC
- Doing business as
- CENTROMED MARIA CASTRO FLORES CLINIC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Mar 22, 2005
- Last certification
- Mar 22, 2005
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Nov 14, 1973 in TX
- Enrollment address
- 7315S Loop 1604 W
Somerset, TX 78069 - Related CCNs
- 451831
All disclosed owners & managing parties 17
| Name | Role | Since | Share |
|---|---|---|---|
| Melinda Perez |
Corporate Director |
Jan 28, 2021 | |
| Donald J Macaulay |
W-2 Managing Employee |
Feb 20, 1995 | |
| Ricardo Perez |
Corporate Officer |
Mar 19, 2009 | |
| Diana M Torres |
Corporate Officer |
Jun 30, 1994 | |
| Elsa Gambo |
Corporate Director |
Jan 23, 2020 | |
| Juan a Chavira |
Corporate Officer |
May 22, 2006 | |
| Rudy Pena |
Corporate Officer |
Sep 1, 2011 | |
| Noemi G Eling |
Corporate Officer |
Feb 27, 1992 | |
| Heriberto Guerra |
Corporate Officer |
Jan 28, 1999 | |
| Luz M Cano |
Corporate Officer | Apr 2, 2015 | |
| Lawrence Charles Walzel |
Corporate Director |
Mar 22, 2005 | |
| W-2 Managing Employee |
Mar 22, 2005 | ||
| Nicolas Jr Rangel |
Corporate Officer |
Mar 23, 2017 | |
| Norma L Green |
Corporate Officer |
Jun 27, 1991 | |
| Ernesto Gomez |
Corporate Director |
Jun 1, 1973 | |
| W-2 Managing Employee |
Nov 14, 1974 | ||
| Arlene James Brown |
Corporate Director |
Mar 14, 2019 | |
| Lorraine Alaniz |
Corporate Director |
Jun 24, 2021 | |
| Elsa I Martinez |
Corporate Officer |
Jun 26, 2014 |
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Centromed City Center Clinic |
Federally qualified health center | Operational/Managerial Control | Jan 3, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050303000663 | TX | Part a Provider - Federally Qualified Health Center (FQHC) | 6800881285 | Practice locations: Somerset, TX |
National Provider Directory
- Tax ID family
- El Centro del Barrio in
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | HBOCS00758-04-00 | TX | Yes |
Addresses
Primary practice location
7315 S. Loop 1604 West
Somerset, TX 78069
Mailing address
3750 Commercial Ave
San Antonio, TX 78221-3117
Phone (210) 334-3700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 120980103 | Medicaid | TX | |
| 120980107 | Medicaid | TX | |
| G60232-03 | Other | TX | DELTA DENTAL |
| 120980105 | Medicaid | TX | |
| 00MT08 | Other | TX | GROUP MEDICARE |
| 102980101 | Medicaid | TX | |
| 120980102 | Medicaid | TX |
Other names
- CentroMed Maria Castro Flores Clinic
Other providers in Somerset, TX
- Delhi Adan-Rice
- Bexar Eye Care PLLC
- Delhi Adan-Rice DDS PA
- Margo Lisa Garza
- Melissa Kay Gillis
- Rene Guardiola
- Julie Hatfield
- Adrian Hernandez
All providers in Somerset, 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 Oct 25, 2019. 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.