CENTRO SAN VICENTE (NPI# 1780761452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780761452 |
| Entity Type | Organization |
| Organization Name | CENTRO SAN VICENTE |
| Practice Address |
13017 Perico St San Elizario TX 79849-1517 |
| Mailing Address |
Po Box 1517 San Elizario TX 79849-1517 |
| Practice Telephone | 9158510999 |
| Practice Fax Number | 9158516060 |
| Mailing Telephone | 9158510999 |
| Mailing Fax Number | 9158516060 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2014-04-30 |
| Authorized Official Name | DR. JOSE LUNA JR. (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9152250670 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| 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 | 130880102 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215473707 | Centro San Vicente | Clinic/Center | 10780 Pebble Hills Blvd, Ste G1, El Paso, TX 79935-2034 | 2017-01-09 |
| 1942670328 | Centro San Vicente | Clinic/Center | 1600 Montana Ave, El Paso, TX 79902-5622 | 2015-09-29 |
| 1841480902 | Centro San Vicente | Clinic/Center | 1208 Myrtle Ave, El Paso, TX 79901-1602 | 2007-07-25 |
| 1831267079 | Centro San Vicente | Clinic/Center | 8061 Alameda Ave, El Paso, TX 79915-4705 | 2006-12-04 |
| Street Address |
13017 PERICO ST |
| City | SAN ELIZARIO |
| State | TX |
| Zip Code | 79849-1517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851830756 | Sun City Speech Therapy, LLC | Speech-Language Pathologist | 1433 Tula Court, San Elizario, TX 79849 | 2017-02-13 |
| 1699987818 | San Elizario Independent School District | Local Education Agency (LEA) | 1050 Chicken Ranch Rd, San Elizario, TX 79849 | 2007-05-03 |
| 1073739447 | Mi Casa P.a.s., Inc | Home Health | 440 Fm 1110, San Elizario, TX 79849 | 2007-04-17 |
| 1801920632 | Centro De Salud Familiar La Fe, Inc. | Clinic/Center | 12101 Socorro Rd., San Elizario, TX 79849 | 2007-03-15 |
| 1629042510 | Christopher Lopez | Specialist/Technologist | 13981 Socorro Rd., San Elizario, TX 79849 | 2006-02-15 |
| 1245202118 | Rosa Romero | Dentist | 1313 San Antonio, San Elizarion, TX 79849 | 2006-02-06 |
| 1134390420 | Manuel Gonzalez | Home Health | 440 Fm 1110, San Elizario, TX 79849 | 2008-03-14 |
| 1154772523 | Jessica Cano | Speech-Language Pathologist | 1433 Tula Ct, San Elizario, TX 79849-0137 | 2016-06-28 |
| 1255620712 | Maria Lourdes Delgado | Dental Hygienist | 1313 San Antonio Street, San Elizario, TX 79849-1030 | 2011-04-05 |
| 1407356280 | Christina Desiray Cortez | Licensed Vocational Nurse | 12536 Camino De La Rosa Rd, San Elizario, TX 79849-7381 | 2018-02-18 |
| Find all providers in zip 79849 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801920632 | Centro De Salud Familiar La Fe, Inc. | Clinic/Center | 12101 Socorro Rd., San Elizario, TX 79849 | 2007-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598366718 | East Texas Border Health Clinic | Clinic/Center | 1411 College Dr, Texarkana, TX 75503-3533 | 2020-11-04 |
| 1366043689 | Legacy Community Health Services, Inc. | Clinic/Center | 1900 Strawn Rd., Houston, TX 77039-2017 | 2020-11-03 |
| 1275134595 | Legacy Community Health Services, Inc | Clinic/Center | 507 Crenshaw Rd., Houston, TX 77034-1543 | 2020-11-03 |
| 1912508235 | Legacy Community Health Services, Inc | Clinic/Center | 120 Westheimer Rd., Suite F, Houston, TX 77006-3332 | 2020-11-03 |
| 1720688534 | Barrio Comprehensive Family Health Care Center, Inc. | Clinic/Center | 11930 Us Highway 90, Suite 110, San Antonio, TX 78252 | 2020-10-30 |
| 1053918516 | Legacy Community Health Services, Inc. | Clinic/Center | 13703 Aldine Westfield Rd, Houston, TX 77039-2001 | 2020-10-07 |
| 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 |
| 1144831835 | Matagorda Episcopal Health Outreach Program | Clinic/Center | 2112 Regional Medical Center Drive Suite 1315, Wharton, TX 77488-9719 | 2020-08-14 |
| 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 | SAN ELIZARIO |
| Zip Code | 79849 |
Please comment or provide details below to improve the information on CENTRO SAN VICENTE.
| 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.