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NPI Code Detail

MEDICARE: CENTRAL TEXAS COMMUNITY HEALTH CENTERS

MEDICARE: CENTRAL TEXAS COMMUNITY HEALTH CENTERS
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)

General Provider Information

NPI Number : 1518333004
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRAL TEXAS COMMUNITY HEALTH CENTERS
Provider Business Mailing Address
First Line : PO BOX 17366
Second Line :
City : AUSTIN
State : TX
Zip : 78760-7366
Country : US
Telephone Number : 512-978-9000
Fax Number :
Provider Business Practice Location Address
First Line : 1705 E 11TH ST
Second Line :
City : AUSTIN
State : TX
Zip : 78702-2709
Country : US
Telephone Number : 512-978-8400
Fax Number :
Authorized Official
Title or Position : CFO
Name : CAROLYN KONECNY
Credential :
Telephone Number : 512-978-9000
Provider Enumeration Date : 08/19/2015
Last Update Date : 08/26/2015

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Directions to “CENTRAL TEXAS COMMUNITY HEALTH CENTERS ” Practice Location

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