Organization
GATEWAY COMMUNITY HEALTH CENTER, INC
Active
Other names
GATEWAY COMMUNITY HEALTH CENTER, INC.
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, LAREDO, TX 78041-1705
(956) 795-8100
(956) 718-6294
Mailing address
1515 PAPPAS ST, LAREDO, TX 78041-1705
(956) 795-8100
(956) 718-6294
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081896501
—
TX
05
—
092953101
—
TX
Enumeration date
07/06/2006
Last updated
09/07/2010
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