Healthcare Provider Details

I. General information

NPI: 1477909216
Provider Name (Legal Business Name): HOUSTON COMMUNITY HEALTH CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2016
Last Update Date: 05/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 BOYLES
HOUSTON TX
77020-5299
US

IV. Provider business mailing address

424 HAHLO ST
HOUSTON TX
77020-3022
US

V. Phone/Fax

Practice location:
  • Phone: 713-671-4130
  • Fax: 713-671-4133
Mailing address:
  • Phone: 713-674-3326
  • Fax: 713-674-5100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: DANIEL MONTEZ
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 713-674-3326