Organization
HEART OF TEXAS COMMUNITY HEALTH CENTER INC
Active
Organization
HEART OF TEXAS COMMUNITY HEALTH CENTER INC
Active
Other names
Waco Family Medicine - Pharmacy #2
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW POLK PHD (CHIEF OPERATING OFFICER)
(254) 313-4412
Entity
Organization
Contact information
Practice address
1800 GURLEY LN STE 101, WACO, TX 76706-4025
(254) 313-6030
(254) 312-6108
Mailing address
1600 PROVIDENCE DR, SUITE 201, WACO, TX 76707-2261
(254) 313-4307
(254) 313-4467
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146121
—
TX
01
—
4554615
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/21/2009
Last updated
07/02/2025
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