Organization
HEART OF TEXAS COMMUNITY HEALTH CENTER, INC.
Active
Parent organization
HEART OF TEXAS COMMUNITY HEALTH CENTER, INC
Other names
Martin Luther King Community Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
HEART OF TEXAS COMMUNITY HEALTH CENTER, INC
Authorized official
ANNETTE BALLEW CPA (CHIEF FINANCIAL OFFICER)
(254) 313-4282
Entity
Organization
Contact information
Practice address
1911 N MARTIN LUTHER KING JR BLVD, WACO, TX 76704-1438
(254) 313-5000
(254) 313-5099
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
01
—
068160
UNIFORM DATA SET
TX
05
—
342969801
—
TX
05
—
FQ0000676
—
TX
Enumeration date
10/05/2011
Last updated
07/28/2017
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