Provider Demographics
NPI:1164069035
Name:GATEWAY COMMUNITY HEALTH CENTER, INC
Entity Type:Organization
Organization Name:GATEWAY COMMUNITY HEALTH CENTER, INC
Other - Org Name:LAREDO COLLEGE SOUTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELMO
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:956-718-6259
Mailing Address - Street 1:PO BOX 3397
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78044-3397
Mailing Address - Country:US
Mailing Address - Phone:956-718-6259
Mailing Address - Fax:956-718-6294
Practice Address - Street 1:5500 S. ZAPATA HWY.
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78046-8919
Practice Address - Country:US
Practice Address - Phone:956-795-8100
Practice Address - Fax:956-622-7750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-10
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility