EL CENTRO DEL BARRIO INC. NPI 1811042567

NPI Information

NPI: 1811042567
Provider Name: EL CENTRO DEL BARRIO, INC.

Doing Business As: CENTROMED SOUTH PARK DENTAL

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
910 WAGNER AVE
SAN ANTONIO, TX
ZIP 78211
Phone: (210) 924-7344
Get Directions

EL CENTRO DEL BARRIO, INC. is a federally qualified health center (fqhc) clinic center in San Antonio, TX. EL CENTRO DEL BARRIO, INC. NPI is 1811042567. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Centromed South Park Dental.

The provider's business location address is:

910 WAGNER AVE
SAN ANTONIO, TX
ZIP 78211-213
Phone: (210) 924-7344
Fax: (210) 923-7929

The provider's authorized official is Chuck Walzel .
The authorized official title is Cfo and has the following contact phone number (210) 334-3724.

The enumeration date for this NPI number is 1/24/2007 and was last updated on 5/9/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	HBOCS00758-04-00	TEXAS	No
2	261QS0112X	Clinic/Center	Oral and Maxillofacial Surgery	HBOCS00758-04-00	TEXAS	No
3	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	HBOCS00758-04-00	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	120980102	MEDICAID	TEXAS
2	120980105	MEDICAID	TEXAS
3	00MT08	OTHER	TEXAS	GROUP MEDICARE
4	120980103	MEDICAID	TEXAS
5	120980101	MEDICAID	TEXAS
6	451834	MEDICARE OSCAR/CERTIFICATION	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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