=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649343211
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EL CENTRO DEL BARRIO, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/15/2006
-----------------------------------------------------
Last Update Date | 11/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7404 W US HIGHWAY 90 BLDG. 37
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78227-4024
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-733-8810
-----------------------------------------------------
Fax | 210-674-2877
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3750 COMMERCIAL AVE
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78221-3117
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-922-7000
-----------------------------------------------------
Fax | 210-924-1374
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | CHUCK WALZEL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 210-334-3724
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QF0400X
-----------------------------------------------------
Taxonomy Name | Federally Qualified Health Center (FQHC)
-----------------------------------------------------
License Number | HBOCS007758-04-00
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------