Organization
CENTRAL TEXAS COMMUNITY HEALTH CENTERS
Active
Other names
CommUnityCare
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY MIDDLETON CPCS (MANAGED CARE CONTRACT MANAGER)
(512) 978-9427
Entity
Organization
Contact information
Practice address
4614 N IH 35, AUSTIN, TX 78751-3401
(512) 978-9100
(512) 901-9751
Mailing address
4614 N IH 35, AUSTIN, TX 78751-3401
(512) 978-9139
(512) 978-9141
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2046666-01
—
TX
01
—
2097549
PK
—
Enumeration date
06/30/2006
Last updated
09/22/2021
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