Organization
GATEWAY COMMUNITY HEALTH CENTER, INC.
Active
Other names
GATEWAY COMMUNITY HEALTH CENTER, INC. QUAD CITY COMMUNITY CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIGUEL TREVINO JR. (CEO)
(956) 523-3646
Entity
Organization
Contact information
Practice address
1515 PAPPAS ST, 1515 PAPPAS ST, LAREDO, TX 78041-1705
(956) 523-3642
(956) 718-6294
Mailing address
917 N MAIN STREET, MIRANDO, TX 78369-0220
(956) 523-3642
(956) 795-8135
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092953101
—
TX
01
—
1013948447
NPI FOR MEDICARE NUMBER 451961
TX
05
—
1922020015
—
TX
Enumeration date
07/19/2006
Last updated
08/27/2011
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