MEDICARE: SACRED HEART COMMUNITY CLINIC

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	207QA0505X	Adult Medicine Physician

General Provider Information

NPI Number	:	1235061938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SACRED HEART COMMUNITY CLINIC

Provider Business Mailing Address
First Line	:	PO BOX 561
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78680-0561
Country	:	US
Telephone Number	:	512-716-3929
Fax Number	:	512-716-3998

Provider Business Practice Location Address
First Line	:	620 ROUND ROCK WEST DR BLDG 8
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-5087
Country	:	US
Telephone Number	:	512-716-3929
Fax Number	:	512-716-3998

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	CHRISTOPHER RIVERA
Credential	:
Telephone Number	:	512-716-3929

Provider Enumeration Date	:	05/29/2026
Last Update Date	:	05/29/2026

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Directions to “SACRED HEART COMMUNITY CLINIC ” Practice Location

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