NPIMap

Organization Active NPI

Stephen F Austin Community Health Center,Inc

Doing business as Bacliff Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Bacliff, TX
National Provider Identifier
1962986562
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
STEPHEN F AUSTIN COMMUNITY HEALTH CENTER,INC
Doing business as
Bacliff Community Health Network
Practice address
1136 Grand Ave
Bacliff, TX 77518-2760
Phone
(281) 824-1480
Fax
(281) 220-6407
NPI assigned
Sep 19, 2018
Last updated
Nov 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2025

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

Authorized official

Name
Mark David Young
Title
Ceo
Phone
(281) 824-1480

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X NU
Community Health Clinic/Center 261QC1500X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

1136 Grand Ave
Bacliff, TX 77518-2760

Mailing address

1111 W Adoue St
Alvin, TX 77511-2718
Phone (281) 824-1480

Other names 1

  • Bacliff Community Health Network Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251121001704 TX Part A Provider - Federally Qualified Health Center (FQHC) 6204977127 Practice locations: Bacliff, TX

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1962986562. Details of each certification follow.

Federally qualified health center certification: CCN 971089

Legal name
STEPHEN F AUSTIN COMMUNITY HEALTH CENTER, INC.
Doing business as
BACLIFF COMMUNITY HEALTH NETWORK
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 16, 2025
Last certification
Oct 16, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
1136 Grand Ave
Bacliff, TX 77518-2760

Federally qualified health center certification: CCN 451049

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
BACLIFF COMMUNITY HEALTH NETWORK
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 6, 2019
Last certification
Feb 6, 2019
Ownership / control type
For profit – corporation
Facility address
1136 Grand Avenue
Bacliff, TX 77518

Other NPIs with the same Medicare PAC ID 14

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

View all 14

National Provider Directory

National Provider Directory

Locations

101 Brennen Ln
Alvin, TX 77511
Phone (409) 502-6548

2020 E Mulberry St
Angleton, TX 77515
Phone (409) 849-2777

4005 Technology Rd
Ste 1190
Angleton, TX 77515

796 Highway 288 S
#B
Clute, TX 77531

401 N Gulf Blvd
Freeport, TX 77541

905 N Gulf Blvd
Ste 100
Freeport, TX 77541
Phone (281) 824-1470

500 College Dr
Rm B112
Lake Jackson, TX 77566

2360 Gulf Fwy S
#100C
League City, TX 77573

9430 Broadway St
Ste 120
Pearland, TX 77584
Phone (713) 442-7400

17500 Highway 3
Webster, TX 77598

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Marbella Hooper Individual Corporate DirectorBoard Member Secretary Aug 1, 2017 100%
Mark Young Individual 5% Or Greater Direct Ownership InterestCeo Apr 1, 2010 100%
Corporate OfficerCeo Apr 1, 2010 100%
Corporate DirectorCeo Apr 1, 2010 100%
Debra Fontenot Individual Corporate DirectorBoard Member Aug 21, 2018 100%
Bonnie Horton Individual Corporate DirectorBoard Member Apr 8, 2008 100%
Gina Adams Individual Corporate DirectorBoard Member Vice Chair Jan 1, 2015 100%
Linh Tran Individual W-2 Managing EmployeeCfo Apr 7, 2016

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Stephen F Austin Community Health Center, Inc.Alvin, TX, CCN 671934 Federally qualified health center Operational/Managerial Control Nov 24, 2009
Mychn CallawayAlvin, TX, CCN 741976 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 2017
Women and Children's Health CenterAlvin, TX, CCN 451000 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 3, 2016
Pearland Family Health CenterPearland, TX, CCN 451039 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 9, 2018
Mychn WebsterWebster, TX, CCN 971091 Federally qualified health center 5% Or Greater Direct Ownership Interest Feb 16, 2017

Owned or controlled facilities with NPI records 5

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

Practitioners & affiliated clinicians

Practitioners 180

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 180

NPI Registry JSON

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764115200000",
    "number": "1962986562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W ADOUE ST",
            "city": "ALVIN",
            "state": "TX",
            "postal_code": "775112718",
            "telephone_number": "281-824-1480",
            "fax_number": "281-220-6407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 GRAND AVE",
            "city": "BACLIFF",
            "state": "TX",
            "postal_code": "775182760",
            "telephone_number": "281-824-1480",
            "fax_number": "281-220-6407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN F AUSTIN COMMUNITY HEALTH CENTER,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-19",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "281-824-1480"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bacliff Community Health Network",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bacliff Community Health Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bacliff, TX

Sources for this page

Verify at the official NPI Registry.