NPIMap

Organization Active NPI

El Centro del Barrio, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Antonio, TX
National Provider Identifier
1861211567
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
EL CENTRO DEL BARRIO, INC.
Practice address
4300 Thousand Oaks Dr.
San Antonio, TX 78217
Phone
(210) 922-7000
Fax
(210) 924-1374
NPI assigned
Oct 9, 2024
Last updated
Oct 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Authorized official

Name
Lawrence C Walzel, VP/CFO
Title
VP/Cfo
Phone
(210) 334-3724

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

4300 Thousand Oaks Dr.
San Antonio, TX 78217

Mailing address

3750 Commercial Ave
San Antonio, TX 78221-3117
Phone (210) 922-7000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241107000745 TX Part A Provider - Federally Qualified Health Center (FQHC) 6800881285 Practice locations: San Antonio, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861211567. Details of each certification follow.

Federally qualified health center certification: CCN 971031

Legal name
EL CENTRO DEL BARRIO INC
Doing business as
CENTROMED THOUSAND OAKS CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 4, 2024
Last certification
Nov 4, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
4300 Thousand Oaks Dr
San Antonio, TX 78217-2152

Other NPIs with the same Medicare PAC ID 20

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

View all 20

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
45D0993229Centromed - Thousand Oaks4300 Thousand Oaks Dr, San Antonio, TX 78217Provider-performed microscopyNov 6, 2027

National Provider Directory

National Provider Directory
Tax ID family
Centro del Barrio Inc37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

View all 36

Locations

580 Cibolo Valley Dr
Ste 221
Cibolo, TX 78108
Phone (210) 314-1820

1 Haven For Hope Way
Ste 300
San Antonio, TX 78207
Phone (210) 220-2330

10290 Southton Rd
Bldg 4
San Antonio, TX 78223

204 Nolan St
San Antonio, TX 78202
Phone (210) 229-9322

207 E Evergreen St
San Antonio, TX 78212

315 N San Saba
Ste 103
San Antonio, TX 78207
Phone (210) 738-8222

4040 High Ridge Cir
San Antonio, TX 78229
Phone (210) 212-2525

425 Soledad St
Ste 250
San Antonio, TX 78205
Phone (210) 227-2801

5439 Ray Ellison Blvd
San Antonio, TX 78242

7386 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2229

7404 W US Highway 90
#37
San Antonio, TX 78227
Phone (210) 645-6612

910 SW Military Dr
San Antonio, TX 78221
Phone (210) 923-4646

9150 Huebner Rd
Ste 240
San Antonio, TX 78240
Phone (210) 567-5555

920 W Commerce St
San Antonio, TX 78207
Phone (210) 227-2801

920W Commerce St
San Antonio, TX 78207
Phone (210) 227-2801

5253 Walzem Rd
Windcrest, TX 78218
Phone (210) 651-1050

5542 Walzem Rd
Windcrest, TX 78218
Phone (210) 637-2450

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Melinda Perez Individual Corporate DirectorBoard Member Jan 28, 2021
Donald J Macaulay Individual W-2 Managing EmployeeChief Operational Officer Feb 20, 1995
Ricardo Perez Individual Corporate DirectorBoard Member Mar 19, 2009
Diana M Torres Individual Corporate DirectorBoard Member Jun 30, 1994
Elsa Gambo Individual Corporate DirectorBoard Member Jan 23, 2020
Juan a Chavira Individual Corporate DirectorBoard Member May 22, 2006
Rudy Pena Individual Corporate DirectorBoard Member Sep 1, 2011
Heriberto Guerra Individual Corporate DirectorBoard Member Jan 28, 1999
Luz M Cano Individual Corporate DirectorBoard Member Apr 2, 2015
Lawrence Charles Walzel Individual W-2 Managing EmployeeVP / Chief Financial Officer Feb 16, 1998
Nicolas Jr Rangel Individual Corporate DirectorBoard Member Mar 23, 2017
Norma L Green Individual Corporate DirectorBoard Member Jun 27, 1991
Ernesto Gomez Individual Corporate DirectorPresident & Ceo Jun 1, 1973
W-2 Managing EmployeePresident & Ceo Jun 1, 1973
Arlene James Brown Individual Corporate DirectorBoard Members Mar 14, 2019
Lorraine Alaniz Individual Corporate DirectorBoard Member Jun 26, 2014
Elsa I Martinez Individual Corporate DirectorBoard Member Jun 26, 2014

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Centromed City Center ClinicSan Antonio, TX, CCN 451166 Federally qualified health center Operational/Managerial Control Jan 3, 2022

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 105

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.

View all 105

NPI Registry JSON

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1861211567",
    "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": "210-922-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 THOUSAND OAKS DR.",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78217",
            "telephone_number": "210-922-7000",
            "fax_number": "210-924-1374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL CENTRO DEL BARRIO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "WALZEL",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "210-334-3724",
        "authorized_official_credential": "VP/CFO"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.