Healthcare Provider Details

I. General information

NPI: 1629271648
Provider Name (Legal Business Name): GATEWAY COMMUNITY HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 N. RATHMELL AVENUE
ZAPATA TX
78076-0098
US

IV. Provider business mailing address

PO BOX 3397
LAREDO TX
78044-3397
US

V. Phone/Fax

Practice location:
  • Phone: 956-765-3825
  • Fax: 956-718-6294
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: MR. ELMO LOPEZ JR.
Title or Position: CEO
Credential:
Phone: 956-718-6259