Provider Demographics
NPI:1205572047
Name:FAMILY HEALTH CENTER
Entity type:Organization
Organization Name:FAMILY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL ADMINISTRATOR PATIENT SERV
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:COSME-THILLET
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:210-990-4483
Mailing Address - Street 1:5975 FM 78 STE 280
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78244-1012
Mailing Address - Country:US
Mailing Address - Phone:210-990-4483
Mailing Address - Fax:
Practice Address - Street 1:5975 FM 78 STE 280
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78244-1012
Practice Address - Country:US
Practice Address - Phone:210-990-4483
Practice Address - Fax:210-855-9904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center