Provider Demographics
NPI:1952339475
Name:CENTRAL TEXAS COMMUNITY HEALTH CENTERS
Entity Type:Organization
Organization Name:CENTRAL TEXAS COMMUNITY HEALTH CENTERS
Other - Org Name:COMMUNITYCARE--ROSEWOOD-ZARAGOSA
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:SLOAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-978-9000
Mailing Address - Street 1:PO BOX 17366
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78760-7366
Mailing Address - Country:US
Mailing Address - Phone:512-978-9000
Mailing Address - Fax:512-978-9001
Practice Address - Street 1:2802 WEBBERVILLE RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-2947
Practice Address - Country:US
Practice Address - Phone:512-978-9400
Practice Address - Fax:512-978-9457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2046906-01Medicaid
TX2046906-01Medicaid
TX451888Medicare Oscar/Certification