Provider Demographics
NPI:1174690580
Name:COMMUNITY HEALTH CHOICE, INC.
Entity Type:Organization
Organization Name:COMMUNITY HEALTH CHOICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:ROYCE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-295-2201
Mailing Address - Street 1:2636 SOUTH LOOP W
Mailing Address - Street 2:SUITE 700
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2680
Mailing Address - Country:US
Mailing Address - Phone:713-295-2268
Mailing Address - Fax:713-295-7047
Practice Address - Street 1:2636 SOUTH LOOP W
Practice Address - Street 2:SUITE 700
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2680
Practice Address - Country:US
Practice Address - Phone:713-295-2268
Practice Address - Fax:713-295-7047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28-094693302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization