Provider Demographics
NPI:1790850691
Name:FORT BEND FAMILY HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:FORT BEND FAMILY HEALTH CENTER, INC.
Other - Org Name:WALLER CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BIBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-633-3106
Mailing Address - Street 1:400 AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-4406
Mailing Address - Country:US
Mailing Address - Phone:281-342-4530
Mailing Address - Fax:281-342-3832
Practice Address - Street 1:REDA BLAND EVANS AT O.J. BAKER STREET
Practice Address - Street 2:OWEN FRANKLIN HEALTH CTR, 2ND FL., PRAIRIE VIEW A&M
Practice Address - City:PRAIRIE VIEW
Practice Address - State:TX
Practice Address - Zip Code:77446
Practice Address - Country:US
Practice Address - Phone:936-857-2726
Practice Address - Fax:936-857-2725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)