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General NPI Number Information
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NPI Number | 1245569201
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Entity Type | Organization
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Legal Business Name | HEART OF TEXAS COMMUNITY HEALTH CENTER INC
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Dates
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Enumeration Date | 12/21/2009
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 1800 GURLEY LN STE 101
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City | WACO
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State | TX
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Zip | 76706-4025
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Country | US
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Telephone | 254-313-6030
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Fax | 254-312-6108
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Provider Business Mailing Address
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Address Line | 1600 PROVIDENCE DR SUITE 201
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City | WACO
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State | TX
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Zip | 76707-2261
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Country | US
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Telephone | 254-313-4307
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Fax | 254-313-4467
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | DR. MATTHEW POLK
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Credential | PHD
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Telephone | 254-313-4412
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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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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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