Provider Demographics
NPI:1114627122
Name:NORTH CENTRAL TEXAS COMMUNITY HEALTH CARE CENTER, INC
Entity Type:Organization
Organization Name:NORTH CENTRAL TEXAS COMMUNITY HEALTH CARE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON, CHIEF EXECUTIVE OFFICER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-766-6306
Mailing Address - Street 1:200 MLK JR BLVD
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-1152
Mailing Address - Country:US
Mailing Address - Phone:940-397-2609
Mailing Address - Fax:940-264-2857
Practice Address - Street 1:2015 YAMPARIKA ST
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:TX
Practice Address - Zip Code:76384-6179
Practice Address - Country:US
Practice Address - Phone:940-766-6306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)