Healthcare Provider Details

I. General information

NPI: 1851003818
Provider Name (Legal Business Name): SPRING BRANCH COMMUNITY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2022
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 FROSTWOOD DR
HOUSTON TX
77024-2420
US

IV. Provider business mailing address

5502 1ST ST
KATY TX
77493-2472
US

V. Phone/Fax

Practice location:
  • Phone: 713-462-6565
  • Fax:
Mailing address:
  • Phone: 713-462-6565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MARLEN J TRUJILLO
Title or Position: CEO
Credential:
Phone: 713-462-6565