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General NPI Number Information
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NPI Number | 1962986562
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Entity Type | Organization
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Legal Business Name | STEPHEN F AUSTIN COMMUNITY HEALTH CENTER,INC
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Dates
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Enumeration Date | 09/19/2018
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 1136 GRAND AVE
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City | BACLIFF
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State | TX
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Zip | 77518-2760
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Country | US
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Telephone | 281-824-1480
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Fax | 281-220-6407
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Provider Business Mailing Address
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Address Line | 1111 W ADOUE ST
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City | ALVIN
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State | TX
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Zip | 77511-2718
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Country | US
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Telephone | 281-824-1480
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Fax | 281-220-6407
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Authorized Official
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Title or Position | CEO
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Name | MARK DAVID YOUNG
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Credential |
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Telephone | 281-824-1480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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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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