Healthcare Provider Details

I. General information

NPI: 1619796562
Provider Name (Legal Business Name): BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2024
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 BROADWAY ST STE 100
SAN ANTONIO TX
78215-1148
US

IV. Provider business mailing address

3066 E COMMERCE ST
SAN ANTONIO TX
78220-1013
US

V. Phone/Fax

Practice location:
  • Phone: 210-233-7000
  • Fax: 210-251-3194
Mailing address:
  • Phone: 210-233-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MR. HUNG-VY NGUYEN
Title or Position: CEO
Credential:
Phone: 210-233-7000