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General NPI Number Information
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NPI Number | 1184643256
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Entity Type | Organization
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Legal Business Name | GATEWAY COMMUNITY HEALTH CENTER, INC.
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 08/27/2011
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Provider Practice Location Address
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Address Line | 1515 PAPPAS ST 1515 PAPPAS ST
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City | LAREDO
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State | TX
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Zip | 78041-1705
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Country | US
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Telephone | 956-523-3642
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Fax | 956-718-6294
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Provider Business Mailing Address
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Address Line | 917 N MAIN STREET
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City | MIRANDO
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State | TX
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Zip | 78369-0220
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Country | US
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Telephone | 956-523-3642
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Fax | 956-795-8135
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Authorized Official
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Title or Position | CEO
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Name | MR. MIGUEL TREVINO JR.
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Credential |
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Telephone | 956-523-3646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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