BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC. (NPI# 1568519122) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568519122 |
| Entity Type | Organization |
| Organization Name | BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC. |
| Other Organization Name | LEON COUNTY COMMUNITY HEALTH CENTER |
| Practice Address |
607 Lassater Centerville TX 75833 |
| Mailing Address |
1500 University Dr E #100 College Station TX 77840-2600 |
| Practice Telephone | 9035363687 |
| Practice Fax Number | 9035367723 |
| Mailing Telephone | 9798461100 |
| Mailing Fax Number | 9792609390 |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2014-11-10 |
| Authorized Official Name | ERIC V. TODD (CHIEF EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9798461100 |
| Is Organization Subpart | Y |
| Parent Organization Name | BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 000951606 | 05 | |
| TX | 185649401 | 05 |
| Other Name | Type Code |
|---|---|
| Leon County Community Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841562451 | Brazos Valley Community Action Agency, Inc. | Clinic/Center | 808 W. Hwy 79, Franklin, TX 77856-1728 | 2012-01-30 |
| 1427331651 | Brazos Valley Community Action Agency, Inc. | Clinic/Center | 17202 State Highway 36 S., Somerville, TX 77879-4157 | 2011-09-23 |
| 1275620551 | Brazos Valley Community Action Agency, Inc. | Clinic/Center | 1002 W Brown St, Hearne, TX 77859-3063 | 2006-10-06 |
| 1821185299 | Brazos Valley Community Action Agency, Inc. | Clinic/Center | 1500 University Dr E, #100, College Station, TX 77840-2600 | 2006-10-06 |
| 1649265646 | Brazos Valley Community Action Agency, Inc. | Clinic/Center | 3370 S Texas Ave, Suite B, Bryan, TX 77802-3127 | 2005-09-15 |
| 1881244978 | Brazos Valley Community Action Agency, Inc. | Clinic/Center | 1701 Pecos Ave, Rockdale, TX 76567-2570 | 2019-09-19 |
| 1649689274 | Brazos Valley Community Action Agency, Inc. | Clinic/Center | 215 Fm 1488 Road, Hempstead, TX 77445 | 2014-08-07 |
| 1871916981 | Brazos Valley Community Action Agency, Inc. | Clinic/Center | 302 W Highway 21, Caldwell, TX 77836-1122 | 2014-01-24 |
| 1497183883 | Brazos Valley Community Action Agency, Inc. | Clinic/Center | 1301 Memorial Dr, Bryan, TX 77802-5205 | 2013-10-22 |
| 1912268426 | Brazos Valley Community Action Agency, Inc. | Clinic/Center | 2700 E 29th St, 300, Bryan, TX 77802-2531 | 2012-05-31 |
| Street Address |
607 LASSATER |
| City | CENTERVILLE |
| State | TX |
| Zip Code | 75833 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972549947 | Shirley Jeanne Baker | Physician Assistant | 607 Lassater, Centerville, TX 78533 | 2006-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881175313 | Texas Guardian Hcs, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2884 State Highway 75 S, Centerville, TX 75833 | 2018-08-23 |
| 1952897324 | Candace Arnell West | Registered Nurse | 6585 Fm 1511, Centerville, TX 75833 | 2018-07-09 |
| 1548621303 | Leon County | Voluntary or Charitable | 529 W Lassater, Centerville, TX 75833 | 2016-03-08 |
| 1255414744 | St. Joseph Regional Health Center | Clinic/Center | 102 West Main St., Centerville, TX 75833 | 2006-10-20 |
| 1861400798 | Homeland Lp | Durable Medical Equipment & Medical Supplies | 143 S Cass Street, Centerville, TX 75833 | 2006-08-04 |
| 1174591648 | Rtm Enterprises Inc | Ambulance | 309 West Main, Centerville, TX 75833 | 2006-03-10 |
| 1801910609 | Glen Ross Pettenger | Physician Assistant | 102 West Main Street, Centerville, TX 75833 | 2007-03-19 |
| 1730295775 | Dennis James Ellison | Dentist | 912 N. Commerce St., Centerville, TX 75833-0129 | 2006-08-22 |
| 1235688755 | Justin Henne | Nurse Practitioner | 607 W Lassater, Centerville, TX 75833-1959 | 2016-09-26 |
| 1801251889 | Kelli Franklin | Counselor | 205 S Commerce St, Centerville, TX 75833-1965 | 2015-12-17 |
| Find all providers in zip 75833 | ||||
| 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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| Find all providers with the same taxonomy | ||||
| City | CENTERVILLE |
| Zip Code | 75833 |
Please comment or provide details below to improve the information on BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC..
| 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.