Organization
HEART OF TEXAS COMMUNITY HEALTH CENTER, INC
Active
Other names
Austin Avenue Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE BALLEW CPA (CFO)
(254) 313-4282
Entity
Organization
Contact information
Practice address
110 S 12TH ST, WACO, TX 76701-1810
(254) 313-6350
(254) 313-4531
Mailing address
1600 PROVIDENCE DR, WACO, TX 76707-2261
(254) 313-4200
(254) 313-4326
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
342899701
—
TX
Enumeration date
07/08/2014
Last updated
07/28/2017
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