MEDICARE: GATEWAY COMMUNITY HEALTH CENTER, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0005X	Ambulatory Family Planning Facility
2	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1194298224
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GATEWAY COMMUNITY HEALTH CENTER, INC

Provider Business Mailing Address
First Line	:	PO BOX 3397
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78044-3397
Country	:	US
Telephone Number	:	956-718-6259
Fax Number	:	956-718-6294

Provider Business Practice Location Address
First Line	:	208 SHILOH DR STE 1
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78045-7402
Country	:	US
Telephone Number	:	956-795-8100
Fax Number	:	877-897-4368

Authorized Official
Title or Position	:	CEO
Name	:	ELMO LOPEZ
Credential	:
Telephone Number	:	956-718-6259

Provider Enumeration Date	:	01/11/2019
Last Update Date	:	06/24/2026

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