NPIMap

Organization Active NPI

Gonzales Healthcare Systems

Doing business as Sievers Medical Clinic - Waelder

  • Rural Health Clinic/Center
  • Waelder, TX
National Provider Identifier
1811999337
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GONZALES HEALTHCARE SYSTEMS
Doing business as
Sievers Medical Clinic - Waelder
Practice address
1818 E US Hwy 90
Waelder, TX 78959
Phone
(830) 672-7581
Fax
(830) 672-2401
NPI assigned
Aug 15, 2005
Last updated
Feb 26, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
GONZALES HEALTHCARE SYSTEMSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Authorized official

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

Specialties & licenses 3

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

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 names 1

  • Sievers Medical Clinic - Waelder Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811999337. Details of each certification follow.

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
OtherNon-profit
Incorporated
May 13, 1975 in TX
Enrollment address
1818 East US Highway 90
Waelder, TX 78959-4001
Related CCNs
450235

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

Other NPIs with the same Medicare PAC ID 7

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

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
45D0875699Sievers Medical Clinic - Waelder1818 E US Hwy 90, Waelder, TX 78959Certificate of waiverAug 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Gonzales Healthcare Systems13 organizations share this tax ID, including this one
Part of
Gonzales Healthcare Systems

Other organizations with this tax ID 12

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

Ownership & related parties

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 OfficerCeo 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 OfficerCfo Jul 5, 2023
Kenneth Gottwald Individual Corporate DirectorBoard 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 DirectorDirector May 5, 2018

Owners & managing parties with NPI records 7

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

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

Owned or controlled facilities with NPI records 7

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

Facilities with the same owner 6

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

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1811999337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 587",
            "city": "GONZALES",
            "state": "TX",
            "postal_code": "786290587",
            "telephone_number": "830-672-7581",
            "fax_number": "830-672-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 E US HWY 90",
            "city": "WAELDER",
            "state": "TX",
            "postal_code": "78959",
            "telephone_number": "830-672-7581",
            "fax_number": "830-672-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GONZALES HEALTHCARE SYSTEMS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GONZALES HEALTHCARE SYSTEMS",
        "enumeration_date": "2005-08-15",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "ANZALDUA",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "CEO ADMINISTRATOR",
        "authorized_official_telephone_number": "830-672-7581",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "000103",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "000103",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sievers Medical Clinic - Waelder",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sievers Medical Clinic - Waelder",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waelder, TX

Sources for this page

Verify at the official NPI Registry.