Organization
EL CENTRO DEL BARRIO
Active
Other names
CentroMed
Organization subpart
No
Provider details
NPI number
Authorized official
CHUCK WALZEL M.B.A. (CFO)
(210) 334-3724
Entity
Organization
Contact information
Practice address
3750 COMMERCIAL AVE, SAN ANTONIO, TX 78221-3117
(210) 334-3700
(210) 922-0162
Mailing address
3750 COMMERCIAL AVE, SAN ANTONIO, TX 78221-3117
(210) 334-3700
(210) 922-0162
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
HBOCS00758-04-00
TX
208M00000X
Hospitalist Physician
HBOCS00758-04-00
TX
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
HBOCS00758-04-00
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120980101
—
TX
05
—
120980102
—
TX
05
—
120980103
—
TX
05
—
120980105
—
TX
05
—
188815801
—
TX
01
—
8G8244
BCBS
TX
Enumeration date
11/02/2007
Last updated
07/16/2009
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