| Community Health Centers Of South Central Texas, Inc. | |
|
228 Saint George St Gonzales TX 78629-3910 | |
| (830) 672-6511 | |
| (830) 672-3024 |
| Full Name | Community Health Centers Of South Central Texas, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 228 Saint George St, Gonzales, Texas |
| Authorized Official Name and Position | Rafael De La Paz (CEO) |
| Authorized Official Contact | 8306726511 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Centers Of South Central Texas, Inc. Po Box 1890 Gonzales TX 78629-1390 Ph: (830) 672-6511 | Community Health Centers Of South Central Texas, Inc. 228 Saint George St Gonzales TX 78629-3910 Ph: (830) 672-6511 |
| NPI Number | 1285650424 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 05/13/2024 |
| Medicare PECOS PAC ID | 4688650328 |
|---|---|
| Medicare Enrollment ID | O20040624001546 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285650424 | NPI | - | NPPES |
| 00HE62 | Other | TX | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Nicolas Eduardo Trujillo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073511887 PECOS PAC ID: 8820070550 Enrollment ID: I20040604000885 |
| Provider Name | Mary Jane Wray |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588633499 PECOS PAC ID: 1951386804 Enrollment ID: I20040623001057 |
| Provider Name | Roland A Medellin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184626871 PECOS PAC ID: 3577510197 Enrollment ID: I20050406000351 |
| Provider Name | Debra S Irwin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659386712 PECOS PAC ID: 4981780178 Enrollment ID: I20080328000163 |
| Provider Name | Jerry Flores Castilleja |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720126659 PECOS PAC ID: 7214008879 Enrollment ID: I20080625000497 |
| Provider Name | John W Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881857498 PECOS PAC ID: 1456426816 Enrollment ID: I20080906000042 |
Sievers Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1110 N Sarah Dewitt Dr, Gonzales, TX 78629 Phone: 830-672-7581 Fax: 830-672-2401 | |
Women's Health And Wic Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 229 St. George Street, Gonzales, TX 78629 Phone: 830-672-6511 Fax: 830-672-3981 |