Organization
COMMUNITY HEALTH DEVELOPMENT INC.
Active
Other names
Our Health - Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAYELA CASTANON (CHIEF EXECUTIVE OFFICER)
(830) 278-5604
Entity
Organization
Contact information
Practice address
200 EVANS ST, UVALDE, TX 78801-5142
(830) 278-7105
(830) 278-1836
Mailing address
908 EVANS ST, UVALDE, TX 78801-6034
(830) 278-5604
(830) 278-1836
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00FM20
MEDICARE TRAILBLAZER
TX
05
—
111438102
—
TX
01
—
1184685109
JOHN PEREZ, PA
TX
01
—
1710110457
AMBRISH PATEL, PA
TX
01
—
1851375224
ROLAND PEREZ, PA
TX
01
—
1871576868
PROVIDER NPI
TX
Enumeration date
11/21/2005
Last updated
03/26/2024
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