# COMMUNITY MOTHER AND CHILD HEALTH CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386660744
- **Authorized official:** JUDY GILLEY FNP (MANAGING EMPLOYEE)
- **Authorized official phone:** (361) 570-1082

## Contact information

- **Practice address:** 510 E RIO GRANDE ST, VICTORIA, TX 77901-6033
- **Practice address phone:** (361) 570-1083
- **Mailing address:** 510 E RIO GRANDE ST, VICTORIA, TX 77901-6033
- **Mailing address phone:** (361) 570-1083

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 208D00000X | General Practice Physician | — | TX | Yes |

## Other

- **Enumeration date:** 07/15/2006
- **Last updated:** 12/06/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00929K | DEACTIVATED | TX |
| 05 | — | 0801377601 | — | TX |