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Organization
HEART OF TEXAS COMMUNITY HEALTH CENTER
Active
Organization
HEART OF TEXAS COMMUNITY HEALTH CENTER
Active
Other names
Connally Community Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ALLEN E PATTERSON CPA (CFO)
(254) 750-8202
Entity
Organization
Contact information
Practice address
715 N RITA ST, WACO, TX 76705-1140
(254) 412-2101
(254) 412-2076
Mailing address
1600 PROVIDENCE DR, WACO, TX 76707-2261
(254) 750-8200
(254) 750-8326
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092957202
—
TX
01
—
FQ0000676
MEDICAID
TX
Enumeration date
06/15/2010
Last updated
06/15/2010
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