Basic Information
Provider Information
NPI: 1710439799
EntityType: 2
ReplacementNPI:  
OrganizationName: BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER,INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: COMMUNICARE HEALTH CENTERS
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3066 E COMMERCE ST
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782201013
CountryCode: US
TelephoneNumber: 2102337000
FaxNumber: 2104341704
Practice Location
Address1: 10002 WESTOVER BLUFF
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 78251
CountryCode: US
TelephoneNumber: 2102337000
FaxNumber: 2102775199
Other Information
ProviderEnumerationDate: 10/26/2016
LastUpdateDate: 10/26/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: NGUYEN
AuthorizedOfficialFirstName: PAUL
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 2102337000
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QF0400X  Y Ambulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)

No ID Information.


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