Organization
STEPHEN F AUSTIN COMMUNITY HEALTH CENTER, INC.
Active
Other names
MYCHN LAKEJACKSON, MYCHN LAKE JACKSON
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY GAINES (CREDENTIALING COORDINATOR II)
(281) 824-1480
Entity
Organization
Contact information
Practice address
120 FLAG LAKE DR STE 2, LAKE JACKSON, TX 77566-6292
(281) 824-1480
(281) 220-6407
Mailing address
1612 CALLAWAY DR, ALVIN, TX 77511-3743
(281) 824-1480
(281) 220-6407
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
06/15/2023
Last updated
11/25/2025
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