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Gonzales Healthcare Systems

Organization Active NPI Rural Health Clinic/Center · Waelder, TX

NPI 1811999337 · NPPES record last updated Feb 26, 2024

Key facts

NPI
1811999337
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
GONZALES HEALTHCARE SYSTEMS
Practice address
1818 E US Hwy 90
Waelder, TX 78959
Phone
(830) 672-7581
Fax
(830) 672-2401
NPI assigned
Aug 15, 2005
Organization subpart
Yes
Parent organization (as reported)
GONZALES HEALTHCARE SYSTEMS

Authorized official

Name
Mr. Brandon Anzaldua
Title
Ceo Administrator
Phone
(830) 672-7581

Owners & managing parties with NPI records 7

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

Owned or controlled facilities with NPI records 7

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

Other NPIs with the same Medicare PAC ID 7

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

Corporate family (same tax ID) 14

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

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

Facilities with the same owner 6

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

Practitioners 35

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

View all 35

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0875699Sievers Medical Clinic - Waelder
1818 E US Hwy 90, Waelder, TX 78959		Certificate of waiverAug 29, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Rural health clinic certification: CCN 453481

Legal name
GONZALES HEALTHCARE SYSTEMS
Doing business as
SIEVERS MEDICAL CLINIC - WAELDER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 18, 1993
Last certification
Jun 20, 2022
Ownership / control type
Non-profit – church related
Organization structure
Other · Non-profit
Incorporated
May 13, 1975 in TX
Enrollment address
1818 East US Highway 90
Waelder, TX 78959-4001
Related CCNs
450235

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Brandon Anzaldua
Individual 		Corporate Officer
Ceo		 Aug 1, 2023
Wayne South
Individual 		Corporate Director Jun 4, 2019
Gregory Charles Tieken
Individual 		Corporate Director May 7, 2016
Timothy Markham
Individual 		Corporate Director May 6, 1996
William V Bailey
Individual 		Corporate Officer
Cfo		 Jul 5, 2023
Kenneth Gottwald
Individual 		Corporate Director
Board of Directors		 May 12, 2012
Gene Reed
Individual 		Corporate Director Jun 8, 2010
Kerry Frank Morgan
Individual 		Corporate Director Sep 3, 2013
Juli Clay
Individual 		Corporate Director Dec 1, 2001
W-2 Managing Employee Dec 1, 2001
Gonzales Healthcare Systems
Organization · Gonzales, TX 		Operational/Managerial Control Jul 15, 2010 100%
Lisa Gindler
Individual 		Corporate Director May 8, 1995
Sascha Kardosz
Individual 		Corporate Director
Director		 May 5, 2018

All facility ownership & control disclosures 7

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

FacilityTypeRoleSince
Memorial Hospital
Gonzales, TX · CCN 450235		 Hospital Operational/Managerial Control Jul 15, 2010
The Heights of Gonzales
Gonzales, TX · CCN 676138		 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 31, 2013
Avir at Gonzales
Gonzales, TX · CCN 675124		 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2025
Avir at Magnolia
Luling, TX · CCN 676044		 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2015
Memorial Hospital Home Health Agency
Gonzales, TX · CCN 457634		 Home health agency Other (100%) Jun 1, 1984
Sievers Medical Clinic
Gonzales, TX · CCN 453456		 Rural health clinic Operational/Managerial Control Jul 15, 2010
Sievers Medical Clinic - Shiner
Shiner, TX · CCN 673488		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2020

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20041004001113 TX Part a Provider - Rural Health Clinic 8527963776 Practice locations: Waelder, TX

National Provider Directory

Tax ID family
Gonzales Healthcare Systems (15 organizations share this tax ID)
Part of
Gonzales Healthcare Systems

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X 000103 TX
Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208000000X 000103 TX
Rural Health Clinic/Center 261QR1300X TX Yes

Addresses

Primary practice location

1818 E US Hwy 90
Waelder, TX 78959

Mailing address

PO Box 587
Gonzales, TX 78629-0587
Phone (830) 672-7581

Other identifiers

IdentifierTypeStateIssuer
091887201MedicaidTX
091887202MedicaidTX

Other names

  • Sievers Medical Clinic - Waelder Doing business as

Other providers in Waelder, TX

All providers in Waelder, TX · Rural Health Clinic/Center in Texas

Sources for this page

Verify at the official NPI Registry.