Organization
COMMUNITY ACTION CORPORATION OF SOUTH TEXAS
Active
Parent organization
COMMUNITY ACTION CORPORATION OF SOUTH TEXAS
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY ACTION CORPORATION OF SOUTH TEXAS
Authorized official
ANN AWALT (EXECUTIVE DRIECTOR)
(361) 664-0145
Entity
Organization
Contact information
Practice address
115 W MAIN ST, BENAVIDES, TX 78341
(361) 256-3663
(361) 664-2248
Mailing address
204 E 1ST ST, ALICE, TX 78332-4822
(361) 664-0145
(361) 664-2248
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
L5201
TX
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00QW12
MEDICARE- UNSPEICIED TYPR ID
TX
05
—
205219301
—
TX
Enumeration date
04/28/2009
Last updated
10/04/2013
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