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Organization
HEART OF TEXAS COMMUNITY HEALTH CENTER, INC
Active
Organization
HEART OF TEXAS COMMUNITY HEALTH CENTER, INC
Active
Other names
Riverside Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ALLEN E PATTERSON CPA (CFO)
(254) 750-8202
Entity
Organization
Contact information
Practice address
225 W WACO DR, WACO, TX 76707-3836
(254) 750-5487
Mailing address
1600 PROVIDENCE DR, WACO, TX 76707-2261
(254) 750-8200
(254) 750-8326
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
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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