MEDICARE: SOUTH CENTRAL HOUSTON ACTION COUNCIL INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1023450368
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH CENTRAL HOUSTON ACTION COUNCIL INC

Provider Business Mailing Address
First Line	:	8610 MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77033-2308
Country	:	US
Telephone Number	:	713-734-0199
Fax Number	:	713-734-0286

Provider Business Practice Location Address
First Line	:	4040 YALE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-5928
Country	:	US
Telephone Number	:	713-734-0199
Fax Number	:	713-734-0286

Authorized Official
Title or Position	:	CEO
Name	:	LATOYA DARDEN
Credential	:
Telephone Number	:	713-734-0199

Provider Enumeration Date	:	07/29/2013
Last Update Date	:	06/25/2015

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