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NPI Code Detail

MEDICARE: COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.

MEDICARE: COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, 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
1261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100HE62OTHERTXBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1285650424
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.
Provider Business Mailing Address
First Line : PO BOX 1890
Second Line :
City : GONZALES
State : TX
Zip : 78629-1390
Country : US
Telephone Number : 830-672-6511
Fax Number : 877-540-1081
Provider Business Practice Location Address
First Line : 228 SAINT GEORGE ST
Second Line :
City : GONZALES
State : TX
Zip : 78629-3910
Country : US
Telephone Number : 830-672-6511
Fax Number : 830-672-3024
Authorized Official
Title or Position : CEO
Name : RAFAEL DE LA PAZ
Credential :
Telephone Number : 830-672-6511
Provider Enumeration Date : 07/14/2006
Last Update Date : 05/20/2026

Similar Medicare Providers

1184626871 — DR. ROLAND A MEDELLIN M.D.
Practice Location Address:
228 SAINT GEORGE ST
GONZALES, TX
78629-3910
Practice Phone: 830-672-6511
Practice Fax: 830-672-6430
1922018902 — DR. DAVID STANFORD MURPHY DDS
Practice Location Address:
228 SAINT GEORGE ST
GONZALES, TX
78629-3910
Practice Phone: 830-672-6511
Practice Fax: 830-672-6430
1053322362 — DR. JAMES BENJAMIN QUARTEY DDS
Practice Location Address:
228 SAINT GEORGE ST
GONZALES, TX
78629-3910
Practice Phone: 830-672-6511
Practice Fax: 830-672-6430
1245241405 — MRS. PATRICK ANN CALDWELL WHNP, RNC
Practice Location Address:
228 SAINT GEORGE ST
GONZALES, TX
78629-3910
Practice Phone: 830-672-6511
Practice Fax: 830-672-6430
1487767588 — MR. RAFAEL ANGEL SALAS PSYD
Practice Location Address:
228 SAINT GEORGE ST
GONZALES, TX
78629-3910
Practice Phone: 830-672-6511
Practice Fax: 830-672-6430
1639288848 — MS. TAMMIE LYNN WYRICK DENTAL HYGIENIST
Practice Location Address:
228 SAINT GEORGE ST
GONZALES, TX
78629-3910
Practice Phone: 830-672-6511
Practice Fax: 830-672-6430

Directions to “COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC. ” Practice Location

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