AMISTAD COMMUNITY HEALTH CENTER, INCORPORATED (NPI# 1386770147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386770147 |
| Entity Type | Organization |
| Organization Name | AMISTAD COMMUNITY HEALTH CENTER, INCORPORATED |
| Practice Address |
1533 S. Brownlee Blvd. Ste. 100 Corpus Christi TX 78404-3131 |
| Mailing Address |
1533 S Brownlee Blvd Ste 100 Corpus Christi TX 78404-3131 |
| Practice Telephone | 3618842242 |
| Practice Fax Number | 3618842243 |
| Mailing Telephone | 3618442242 |
| Mailing Fax Number | 3618442243 |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2014-08-18 |
| Authorized Official Name | MR. JOE FLORES (C.E.O.) |
| Authorized Official Telephone | 3618842242 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 191099401 | 05 | |
| TX | MEDICAID TPI MULTISPECIALTY - GROUP | 215071601 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831720176 | Amistad Community Health Center, Incorporated | Clinic/Center | 814 E Main Ave, Robstown, TX 78380-3135 | 2020-01-27 |
| Street Address |
1533 S. BROWNLEE BLVD. STE. 100 |
| City | CORPUS CHRISTI |
| State | TX |
| Zip Code | 78404-3131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942810866 | Eileen Michelle Isaacs | Social Worker | 1315 Sante Fe St. Ste. 215, Corpus Christi, TX 78404 | 2020-08-05 |
| 1386109791 | Sanil John | Specialist/Technologist, Other | South Texas Brain and Spine Centers, 1227 3rd St, Corpus Christi, TX 78404 | 2019-02-11 |
| 1114422599 | Paul Jackson | Student in an Organized Health Care Education/Training Program | 600 Elizabeth St, Gme, Corpus Christi, TX 78404 | 2018-03-27 |
| 1740704303 | Edwin Gabriel Otero | Student in an Organized Health Care Education/Training Program | 600 Elizabeth St # 9b, Corpus Christi, TX 78404 | 2017-07-26 |
| 1053832170 | Melissa D Ponder | Emergency Medicine | 600 Elizabeth St Ste 6b, Corpus Christi, TX 78404 | 2017-06-28 |
| 1821533480 | Collen Mora | Nurse Practitioner | 1533 5th Street, Coprus Christi, TX 78404 | 2017-01-05 |
| 1013365717 | Terri L Sutphin | Speech-Language Pathologist | 1001 Louisiana Ave., Ste #402, Corpus Christi, TX 78404 | 2016-06-03 |
| 1982067872 | Janareddy Mandadi | Pharmacist | 1335 Santa Fe, Shoreline Pharmacy, Corpus Christi, TX 78404 | 2016-03-30 |
| 1932514007 | Debra Carpenter Guzman | Nurse Practitioner | 1600 S Staples, Ste 150, Corpus Christi, TX 78404 | 2014-06-26 |
| 1083037451 | Michelle Lynn Freshcoln Talbert | Registered Nurse | 309 Ohio Ave., Corpus Christi, TX 78404 | 2014-01-21 |
| Find all providers in zip 78404 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1205449386 | Matagorda Episcopal Health Outreach Program | Clinic/Center | 2112 Regional Medical Drive Suite 1305, Wharton, TX 77488 | 2020-08-28 |
| 1568075638 | Matagorda Episcopal Health Outreach Program | Clinic/Center | 2112 Regional Medical Center, Suite 1317, Wharton, TX 77488-9719 | 2020-08-28 |
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| 1780295741 | East Texas Border Health Clinic | Clinic/Center | 705 S Grove St, Marshall, TX 75670-5220 | 2020-08-13 |
| Find all providers with the same taxonomy | ||||
| City | CORPUS CHRISTI |
| Zip Code | 78404 |
Please comment or provide details below to improve the information on AMISTAD COMMUNITY HEALTH CENTER, INCORPORATED.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.