NPIMap

Organization Active NPI

Spring Branch Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Katy, TX
National Provider Identifier
1851741003
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SPRING BRANCH COMMUNITY HEALTH CENTER
Practice address
5502 1St St
Katy, TX 77493-2472
Phone
(713) 462-6565
NPI assigned
Jun 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Authorized official

Name
Marlen J Trujillo, MBA
Title
Chief Executive Officer
Phone
(713) 462-6565

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 172V00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Case Management Agency 251B00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

5502 1St St
Katy, TX 77493-2472

Mailing address

5502 1St St Ste 200
Katy, TX 77493-2472
Phone (713) 462-6565

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL KATY Direct

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040505001669 TX Part B Supplier - Clinic/Group Practice 3072501154 Receives reassigned benefits from 82 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cypress, TX; Katy, TX; Houston, TX
O20170526001400 TX Part A Provider - Federally Qualified Health Center (FQHC) 3072501154 Practice locations: Katy, TX

Federally qualified health center certification: CCN 741957

Legal name
SPRING BRANCH COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 19, 2017
Last certification
May 19, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 14, 2003 in TX
Enrollment address
5502 1St Street
Katy, TX 77493-2472

Other NPIs with the same Medicare PAC ID 8

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
Spring Branch Comm HLTH Ctr12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

5502 1st St
Ste 200
Katy, TX 77493

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Marlen J Trujillo Individual Corporate DirectorCeo Mar 1, 2006
W-2 Managing EmployeeCeo Mar 1, 2006

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Spring Branch Community Health CenterKaty, TX, CCN 741861 Federally qualified health center 5% Or Greater Direct Ownership Interest Aug 18, 2014
Spring Branch Community Health CenterHouston, TX, CCN 741866 Federally qualified health center 5% Or Greater Direct Ownership Interest Aug 18, 2014
Spring Branch Community Health CenterHouston, TX, CCN 741965 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 2016
Spring Branch Community Health CenterHouston, TX, CCN 451196 Federally qualified health center Operational/Managerial Control Mar 1, 2006

Owned or controlled facilities with NPI records 4

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

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726012800000",
    "number": "1851741003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5502 1ST ST STE 200",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774932472",
            "telephone_number": "713-462-6565",
            "fax_number": "832-831-5369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5502 1ST ST",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774932472",
            "telephone_number": "713-462-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING BRANCH COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-20",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A",
        "authorized_official_last_name": "TRUJILLO",
        "authorized_official_first_name": "MARLEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "713-462-6565",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "KATY",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5502 1st St",
            "city": "Katy",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774932472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.