MEDICARE: HOUSTON COMMUNITY HEALTH CENTERS 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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)
2	261QF0400X	Federally Qualified Health Center (FQHC)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093780280
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON COMMUNITY HEALTH CENTERS INC

Provider Business Mailing Address
First Line	:	424 HAHLO ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77020-3022
Country	:	US
Telephone Number	:	713-674-3326
Fax Number	:	713-674-5100

Provider Business Practice Location Address
First Line	:	424B HAHLO STREET
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77020
Country	:	US
Telephone Number	:	713-674-3326
Fax Number	:	713-674-5100

Authorized Official
Title or Position	:	CEO
Name	:	MR. DANIEL MOISES MONTEZ
Credential	:
Telephone Number	:	713-674-3326

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	06/04/2024

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