Organization
HEART OF TEXAS COMMUNITY HEALTH CENTER
Active
Other names
Waco Family Medicine - Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW POLK PHD (CHIEF OPERATING OFFICER)
(254) 313-4412
Entity
Organization
Contact information
Practice address
1600 PROVIDENCE DR, WACO, TX 76707-2261
(254) 313-4307
(254) 313-4520
Mailing address
1600 PROVIDENCE DR, WACO, TX 76707-2261
(254) 313-4307
(254) 313-4520
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150824
—
TX
01
—
4533293
NCPDP
TX
Enumeration date
07/17/2006
Last updated
07/02/2025
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