Provider Demographics
NPI:1629271648
Name:GATEWAY COMMUNITY HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:GATEWAY COMMUNITY HEALTH CENTER, INC.
Other - Org Name:ZAPATA HEALTH CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
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 1:210 N. RATHMELL AVENUE
Practice Address - Street 2:
Practice Address - City:ZAPATA
Practice Address - State:TX
Practice Address - Zip Code:78076-0098
Practice Address - Country:US
Practice Address - Phone:956-765-3825
Practice Address - Fax:956-718-6294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1013948447OtherNPI FOR MEDICARE NUMBER 671918
TX1922020015Medicaid
TX081896501Medicaid
TX092953101Medicaid
TX1922020015Medicaid
TX081896501Medicaid