NPIMap

Organization Active NPI

Legacy Community Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Houston, TX
National Provider Identifier
1912290693
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LEGACY COMMUNITY HEALTH SERVICES, INC
Practice address
3811 Lyons Ave
Houston, TX 77020-4730
Phone
(832) 548-5000
NPI assigned
May 27, 2011
Last updated
Jan 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Authorized official

Name
Robert Peter Palussek
Title
Coo
Phone
(832) 548-5000

Specialties & licenses 1

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

Addresses

Primary practice location

3811 Lyons Ave
Houston, TX 77020-4730

Mailing address

PO Box 66308
Houston, TX 77266-6308
Phone (832) 548-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120607000149 TX Part A Provider - Federally Qualified Health Center (FQHC) 7911969092 1 other NPI on this enrollment
Practice locations: Houston, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912290693. Details of each certification follow.

Federally qualified health center certification: CCN 671849

Legal name
LEGACY COMMUNITY HEALTH SERVICES, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 14, 2007
Last certification
Feb 14, 2007
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 25, 1982 in TX
Enrollment address
3811 Lyons Ave
Houston, TX 77020-8306

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Montrose Clinic Inc77 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Melisa Garcia Individual W-2 Managing EmployeeVP of Clinical Business Services Nov 28, 2007
Allison Wells Individual Corporate DirectorBoard Director Jan 1, 2021 8.33%
Robert Peter Palussek Individual Corporate OfficerCoo and Interim Ceo Nov 20, 2024
Rebekah Le Individual Corporate DirectorBoard Director Dec 1, 2021 8.33%
Ryan Martin Individual Corporate DirectorChairperson Nov 28, 2018 8.33%
Cathy Easter Individual Corporate DirectorDirector Treasurer Feb 1, 2022 8.33%
Neftali Partida Individual Corporate DirectorBoard Director Feb 26, 2020 8.33%
Gary Hammett Individual Corporate DirectorBoard Director Nov 28, 2018 8.33%
Bryan Hlavika Individual Corporate DirectorBoard Director Apr 1, 2012 8.33%
George Hawkins Individual Corporate DirectorBoard Director Jan 17, 2025 8.33%
Legacy Community Health Services, Inc Organization, Houston, TX Corporation, Non-profit Operational/Managerial Control May 15, 2017 100%
Johnson Olatunji Individual Corporate DirectorBoard Director Sep 30, 2015 8.33%
Cynthia Scharringhausen Individual Corporate DirectorBoard Director Dec 1, 2021 8.33%
Ronnie Kurtin Individual Corporate DirectorVice Chairperson Jan 1, 2021 8.33%
Taryn Gore Individual Corporate DirectorDirector Secretary Feb 26, 2020 8.33%

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 20

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

FacilityTypeRoleSince
Legacy Community Health Services, IncHouston, TX, CCN 671985 Federally qualified health center Operational/Managerial Control (100%) Jul 12, 2012
Legacy Community Health Services, IncHouston, TX, CCN 741844 Federally qualified health center Operational/Managerial Control (100%) May 19, 2017
Legacy Community Health Services, IncHouston, TX, CCN 741923 Federally qualified health center Operational/Managerial Control (100%) Jul 21, 2015
N/aHouston, TX, CCN 741951 Federally qualified health center Operational/Managerial Control (100%) May 19, 2017
N/aDeer Park, TX, CCN 741954 Federally qualified health center Operational/Managerial Control (100%) May 22, 2017
N/aBeaumont, TX, CCN 451012 Federally qualified health center Operational/Managerial Control (100%) Jul 9, 2018
Legacy Community Health Services, IncStafford, TX, CCN 451186 Federally qualified health center Operational/Managerial Control (100%) Jan 24, 2022
Legacy Community Health Services, IncHouston, TX, CCN 451187 Federally qualified health center Operational/Managerial Control (100%) Aug 9, 2021
Legacy Community Health Services, IncHouston, TX, CCN 451188 Federally qualified health center Operational/Managerial Control (100%) Aug 1, 2021
Legacy Community Health Services, IncHouston, TX, CCN 671015 Federally qualified health center Operational/Managerial Control (100%) May 16, 2022
Legacy Community Health Services, IncHouston, TX, CCN 671016 Federally qualified health center Operational/Managerial Control (100%) Aug 15, 2022
Legacy Community Health Services, IncHouston, TX, CCN 671020 Federally qualified health center Operational/Managerial Control (100%) Aug 23, 2022
Legacy Community Health Services, IncMissouri City, TX, CCN 971002 Federally qualified health center Operational/Managerial Control (100%) Nov 1, 2022
Legacy Community Health Services, IncBeaumont, TX, CCN 451907 Federally qualified health center Operational/Managerial Control (100%) Dec 19, 2022
N/aHouston, TX, CCN 671121 Federally qualified health center Operational/Managerial Control (100%) Aug 17, 2023
Legacy Community Health Services, IncBaytown, TX, CCN 671128 Federally qualified health center Operational/Managerial Control (100%) Aug 29, 2023
Legacy Community Health Services, IncHouston, TX, CCN 971012 Federally qualified health center Operational/Managerial Control (100%) Jun 7, 2024
Legacy Community Health Services, IncHouston, TX, CCN 971086 Federally qualified health center Operational/Managerial Control (100%) Sep 23, 2025
Legacy Community Health Services, IncHouston, TX, CCN 971085 Federally qualified health center Operational/Managerial Control (100%) Sep 23, 2025
Legacy Community Health Services, IncPasadena, TX, CCN 971090 Federally qualified health center Operational/Managerial Control (100%) Oct 14, 2025

Facilities with the same owner 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1306454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1912290693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66308",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772666308",
            "telephone_number": "832-548-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 LYONS AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770204730",
            "telephone_number": "832-548-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY COMMUNITY HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-27",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A",
        "authorized_official_last_name": "PALUSSEK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "832-548-5000"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.