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Organization

EL CENTRO DEL BARRIO, INC.

Active
Other names
CentroMed Maria Castro Flores Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
CHUCK WALZEL (VP/CFO)
(210) 334-3724
Entity
Organization

Contact information

Practice address
7315 S. LOOP 1604 WEST, SOMERSET, TX 78069
(210) 922-7000
(210) 924-1374
Mailing address
3750 COMMERCIAL AVE, SAN ANTONIO, TX 78221-3117
(210) 334-3700
(210) 922-0162

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
HBOCS00758-04-00
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00MT08
GROUP MEDICARE
TX
05
102980101
TX
05
120980102
TX
05
120980103
TX
05
120980105
TX
05
120980107
TX
01
G60232-03
DELTA DENTAL
TX
Enumeration date
11/20/2006
Last updated
10/25/2019
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