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General NPI Number Information
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NPI Number | 1396904686
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC
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Dates
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Enumeration Date | 06/03/2008
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Last Update Date | 09/03/2020
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Provider Practice Location Address
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Address Line | 111 S. LAUREL AVENUE
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City | LULING
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State | TX
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Zip | 78648-2624
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Country | US
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Telephone | 830-875-6399
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Fax | 830-875-6398
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Provider Business Mailing Address
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Address Line | PO BOX 1890
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City | GONZALES
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State | TX
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Zip | 78629-1390
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Country | US
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Telephone | 830-672-6511
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Fax | 830-672-6430
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Authorized Official
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Title or Position | CEO
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Name | RAFAEL DE LA PAZ
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Credential |
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Telephone | 830-672-6511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0005X
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Taxonomy Name | Ambulatory Family Planning Facility
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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 | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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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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