- Medicare Primary Care in Gonzales, TX

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is a medicare enrolled primary clinic (Clinic/center - Rural Health) in Gonzales, Texas. The current practice location for is 1110 N Sarah Dewitt Dr, Gonzales, Texas. For appointments, you can reach them via phone at (830) 672-7581. The mailing address for is Po Box 587, Gonzales, Texas and phone number is (830) 672-7581.

is licensed to practice in Texas (license number ). The clinic also participates in the medicare program and its NPI number is 1013916287. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (830) 672-7581.

Contact Information

1110 N Sarah Dewitt Dr
Gonzales
TX 78629-3311
(830) 672-7581
(830) 672-2401

Map and Direction


Primary Care Clinic Profile

Full Name
SpecialityClinic/Center
Location1110 N Sarah Dewitt Dr, Gonzales, Texas
Authorized Official Name and PositionBrandon Anzaldua (CEO ADMINISTRATOR)
Authorized Official Contact8306727581
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

Po Box 587
Gonzales
TX 78629-0587

Ph: (830) 672-7581
1110 N Sarah Dewitt Dr
Gonzales
TX 78629-3311

Ph: (830) 672-7581

NPI Details:

NPI Number1013916287
Provider Enumeration Date07/19/2005
Last Update Date02/26/2024

Medicare PECOS Information:

Medicare PECOS PAC ID8527963776
Medicare Enrollment IDO20040316001074

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1013916287NPI-NPPES
130781103MedicaidTX
130781102MedicaidTX
130781104MedicaidTX

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 000130 (Texas)Secondary
208000000XPediatrics 000103 (Texas)Secondary
261QR1300XClinic/center - Rural Health (Texas)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:
Provider NameJennifer S Farris
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1548220270
PECOS PAC ID: 4284616749
Enrollment ID: I20040607001137
Provider NameBrandon Christian Stroh
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1841293628
PECOS PAC ID: 8224073838
Enrollment ID: I20050623000959
Provider NameHumberto J Rivas
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1376547919
PECOS PAC ID: 9638101579
Enrollment ID: I20050831000543
Provider NameLisa D Henderson
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1003898446
PECOS PAC ID: 7315957693
Enrollment ID: I20060502000091
Provider NameChristopher L Walker
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1326225822
PECOS PAC ID: 5991875817
Enrollment ID: I20080604000579
Provider NameJohn W Thomas
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1881857498
PECOS PAC ID: 1456426816
Enrollment ID: I20080906000042
Provider NameCommie Hisey
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1730181421
PECOS PAC ID: 7113052069
Enrollment ID: I20100317000168
Provider NameDavid Meredith
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1427041383
PECOS PAC ID: 0648305599
Enrollment ID: I20100317000195
Provider NameGloria G Box
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1386628246
PECOS PAC ID: 9335242114
Enrollment ID: I20100527000063
Provider NameKathleen Mary Koerner
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1093936171
PECOS PAC ID: 8729149844
Enrollment ID: I20120118000836
Provider NameNicole Atack
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1114268158
PECOS PAC ID: 6608012190
Enrollment ID: I20130430000100
Provider NameCatherine R Carpenter
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1255449286
PECOS PAC ID: 3678558822
Enrollment ID: I20140219000288
Provider NameCynthia Green
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1568565497
PECOS PAC ID: 8628393238
Enrollment ID: I20150202001058
Provider NameSue Hanner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477892206
PECOS PAC ID: 3971806340
Enrollment ID: I20161112000144
Provider NameKody Lee Selzer
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1265894323
PECOS PAC ID: 4385904036
Enrollment ID: I20180129001335
Provider NameDiana Marie Mikulencak-picha
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790283596
PECOS PAC ID: 8527320654
Enrollment ID: I20180329000622
Provider NameSean A Hattenbach
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1225415359
PECOS PAC ID: 9234437435
Enrollment ID: I20180524001372
Provider NameDouglas L Best
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1659321438
PECOS PAC ID: 9234111675
Enrollment ID: I20181012002027
Provider NameHeather Brooke Domel
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1295405371
PECOS PAC ID: 4284032053
Enrollment ID: I20211213001937
Provider NameCelina D Mccown
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1942967500
PECOS PAC ID: 7315337938
Enrollment ID: I20211214000348
Provider NameBradford S Bennett
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1609308105
PECOS PAC ID: 6709134083
Enrollment ID: I20230615002915
Provider NameKristen Wollmuth
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1508647710
PECOS PAC ID: 2668823485
Enrollment ID: I20240105002287
Provider NameOlufolajimi Obembe
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1164630117
PECOS PAC ID: 7315097367
Enrollment ID: I20240912001270
Provider NameAmanda Frederick
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1922839448
PECOS PAC ID: 3476954736
Enrollment ID: I20240917003432
Provider NameDerik Kenworthy
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1861726077
PECOS PAC ID: 5193852077
Enrollment ID: I20240920003617
Provider NameSteven Larsen
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1508953555
PECOS PAC ID: 7517965064
Enrollment ID: I20240924001442
Provider NameJohn Waddell
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1629562582
PECOS PAC ID: 1355699075
Enrollment ID: I20240928000249
Provider NameKimberly Hawn Wright
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1356488605
PECOS PAC ID: 8123159308
Enrollment ID: I20240929000006
Provider NameMatthew Sigley
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1952347270
PECOS PAC ID: 4981872462
Enrollment ID: I20240929000027
Provider NameMark Epstein
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1730525742
PECOS PAC ID: 9638433857
Enrollment ID: I20241010003676
Provider NameJoseph Letham
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1720583024
PECOS PAC ID: 7214396555
Enrollment ID: I20241013000059
Provider NameDevamurugan Chandramohan
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1235166620
PECOS PAC ID: 7810088747
Enrollment ID: I20241013000073
Provider NameGautham Kandukuri
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1174979462
PECOS PAC ID: 5890086680
Enrollment ID: I20241020000002
Provider NameBenjamin T Yunk
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1982100038
PECOS PAC ID: 8729448766
Enrollment ID: I20241020000003
Provider NameHassan Massouh
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1083723969
PECOS PAC ID: 6305815820
Enrollment ID: I20241022003718
Provider NameNikhil R Kanthala
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1063971380
PECOS PAC ID: 7618202151
Enrollment ID: I20241113000262
Provider NameJonathan S Mcdougal
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1255866224
PECOS PAC ID: 3375812050
Enrollment ID: I20241115004212
Provider NameMoayad Tarboush
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1841668308
PECOS PAC ID: 6800187196
Enrollment ID: I20241120003303

Reviews and Comments


Clinic/Center in Gonzales, TX

Community Health Centers Of South Central Texas, Inc.
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 228 Saint George St, Gonzales, TX 78629
Phone: 830-672-6511    Fax: 830-672-3024

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

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.