Provider Demographics
NPI:1700858446
Name:EL CENTRO DE CORAZON
Entity Type:Organization
Organization Name:EL CENTRO DE CORAZON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCELLE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MIR
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:713-660-1880
Mailing Address - Street 1:P.O. BOX 230209
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77223
Mailing Address - Country:US
Mailing Address - Phone:713-660-1880
Mailing Address - Fax:713-926-9105
Practice Address - Street 1:7037 CAPITOL ST.
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77011-4724
Practice Address - Country:US
Practice Address - Phone:713-660-1880
Practice Address - Fax:713-926-9105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-06
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)