Provider Demographics
NPI:1003977943
Name:COMMUNITY ACTION COUNCIL OF SOUTH TEXAS
Entity Type:Organization
Organization Name:COMMUNITY ACTION COUNCIL OF SOUTH TEXAS
Other - Org Name:ROMA HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXEXUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:G
Authorized Official - Last Name:ZARATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-487-2585
Mailing Address - Street 1:PO BOX 98
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-0098
Mailing Address - Country:US
Mailing Address - Phone:956-487-2585
Mailing Address - Fax:956-487-6670
Practice Address - Street 1:683 N CANALES CIR
Practice Address - Street 2:
Practice Address - City:ROMA
Practice Address - State:TX
Practice Address - Zip Code:78584-8053
Practice Address - Country:US
Practice Address - Phone:956-847-2312
Practice Address - Fax:956-849-0143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX451951Medicare ID - Type Unspecified