Centromed Southside Medical Clinic
LBN: El Centro Del Barrio Inc
Centromed Southside Medical Clinic is an health care organization with primary practice located at 3750 Commercial Ave , San Antonio TX 78221-3117. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC). Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty.
El Centro Del Barrio Inc can be contacted via phone (210) 334-3700, or through Walzel, Chuck via phone (210) 334-3724.
Contact Information
Primary practice address
3750 Commercial Ave
San Antonio TX 78221-3117
Phone: (210) 334-3700
Fax: (210) 922-0162
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | HBOCS007758-04-00 | Texas |
| Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) | 261QF0400X | HBOCS00758-04-00 | Texas |
Profile Details
| NPI number | 1104998749 |
|---|---|
| LBN Legal business name | El Centro Del Barrio Inc |
| DBA Doing business as | Centromed Southside Medical Clinic |
| Authorized official | Walzel, Chuck |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 15th, 2006 |
| Last updated | Aug 18th, 2011 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104998749 | NPPES |
| Texas | Other | 00MT08 | GROUP MEDICARE |
| Texas | MEDICAID | 120980106 | GROUP MEDICARE |
| Texas | Other | G60232-01 | GROUP MEDICARE |
| Texas | MEDICAID | 120980102 | GROUP MEDICARE |
| Texas | MEDICAID | 120980103 | GROUP MEDICARE |
| Texas | MEDICAID | 120980101 | GROUP MEDICARE |
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