Provider Demographics
NPI:1275983710
Name:HOUSTON AREA COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:HOUSTON AREA COMMUNITY SERVICES, INC.
Other - Org Name:BOCS DENTAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:FUENTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-426-0027
Mailing Address - Street 1:2150 W 18TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-5200
Mailing Address - Country:US
Mailing Address - Phone:713-426-0027
Mailing Address - Fax:713-426-0211
Practice Address - Street 1:1427 HAWTHORNE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-3711
Practice Address - Country:US
Practice Address - Phone:713-426-0027
Practice Address - Fax:713-426-0211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)