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NPI Code Detail

MEDICARE: HEART OF TEXAS COMMUNITY HEALTH CENTER, INC.

MEDICARE: HEART OF TEXAS COMMUNITY HEALTH CENTER, 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
1207Q00000XFamily Medicine Physician
2261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1417814674
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEART OF TEXAS COMMUNITY HEALTH CENTER, INC.
Provider Business Mailing Address
First Line : 1600 PROVIDENCE DR
Second Line :
City : WACO
State : TX
Zip : 76707-2261
Country : US
Telephone Number : 254-313-5790
Fax Number :
Provider Business Practice Location Address
First Line : 700 S 15TH ST
Second Line :
City : WACO
State : TX
Zip : 76706-1718
Country : US
Telephone Number : 254-313-5790
Fax Number :
Authorized Official
Title or Position : COO
Name : MATTHEW POLK
Credential :
Telephone Number : 254-313-4412
Provider Enumeration Date : 01/08/2026
Last Update Date : 01/08/2026

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Directions to “HEART OF TEXAS COMMUNITY HEALTH CENTER, INC. ” Practice Location

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