Healthcare Provider Details

I. General information

NPI: 1194298224
Provider Name (Legal Business Name): GATEWAY COMMUNITY HEALTH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2019
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 SHILOH DR STE 1
LAREDO TX
78045-7402
US

IV. Provider business mailing address

PO BOX 3397
LAREDO TX
78044-3397
US

V. Phone/Fax

Practice location:
  • Phone: 956-795-8100
  • Fax: 877-897-4368
Mailing address:
  • Phone: 956-718-6259
  • Fax: 956-718-6294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: ELMO LOPEZ
Title or Position: CEO
Credential:
Phone: 956-718-6259