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	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1902373061
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	:	1800 MCCARTY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77029-3761
Country	:	US
Telephone Number	:	713-674-3326
Fax Number	:	713-674-3332

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

Provider Enumeration Date	:	10/26/2018
Last Update Date	:	10/26/2018

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