Provider Demographics
NPI:1356827786
Name:CENTRAL TEXAS COMMUNITY HEALTH CENTERS
Entity Type:Organization
Organization Name:CENTRAL TEXAS COMMUNITY HEALTH CENTERS
Other - Org Name:COMMUNITYCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER CONTRACTING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-978-9914
Mailing Address - Street 1:2115 KRAMER LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-4013
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13207 WRIGHT RD
Practice Address - Street 2:
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-5000
Practice Address - Country:US
Practice Address - Phone:512-978-8531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)