SPRING BRANCH COMMUNITY HEALTH CENTER (NPI# 1548670128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548670128 |
| Entity Type | Organization |
| Organization Name | SPRING BRANCH COMMUNITY HEALTH CENTER |
| Practice Address |
19333 Clay Rd Katy TX 77449-4001 |
| Mailing Address |
800 W Sam Houston Pkwy S Ste 200 Houston TX 77042-1914 |
| Practice Telephone | 7134626555 |
| Practice Fax Number | 7134626581 |
| Mailing Telephone | 7134626565 |
| Mailing Fax Number | 7134626596 |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2020-11-03 |
| Authorized Official Name | MARLEN TRUJILLO (CEO) |
| Authorized Official Telephone | 7134626565 |
| Is Organization Subpart | Y |
| Parent Organization Name | SPRING BRANCH COMMUNITY HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
TX | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 337890301 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093186728 | Spring Branch Community Health Center | Clinic/Center | 1905 Jacquelyn Dr # 101, Houston, TX 77055-2502 | 2015-10-07 |
| 1114223005 | Spring Branch Community Health Center | Dentist | 7777 Westgreen Blvd, Cypress, TX 77433 | 2011-02-10 |
| 1558688135 | Spring Branch Community Health Center | Clinic/Center | 8575 Pitner Rd, Houston, TX 77080-2010 | 2010-04-22 |
| 1235141409 | Spring Branch Community Health Center | Clinic/Center | 1615 Hlllendahl Boulevard, Suite 100, Houston, TX 77055-3402 | 2006-08-13 |
| 1972094928 | Spring Branch Community Health Center | Dentist | 19333 Clay Rd, Katy, TX 77449-4001 | 2018-05-25 |
| 1871022467 | Spring Branch Community Health Center | Clinic/Center | 7777 Westgreen Blvd, Cypress, TX 77433-0190 | 2017-06-07 |
| 1851741003 | Spring Branch Community Health Center | Clinic/Center | 5502 1st St, Katy, TX 77493-2472 | 2016-06-20 |
| 1811125008 | Spring Branch Community Health Center | Community/Behavioral Health | 1615 Hillendahl Blvd, Suite 100, Houston, TX 77055-0000 | 2009-06-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SPRING BRANCH COMMUNITY HEALTH CENTER | 800 W Sam Houston Pkwy S Ste 20, Houston, TX 77042-1908 |
| Street Address |
19333 CLAY RD |
| City | KATY |
| State | TX |
| Zip Code | 77449-4001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962503243 | David Wayne Krusleski | Family Medicine | 19333 Clay Rd, Katy, TX 77449-4001 | 2006-09-26 |
| 1972094928 | Spring Branch Community Health Center | Dentist | 19333 Clay Rd, Katy, TX 77449-4001 | 2018-05-25 |
| 1265964902 | Andrea Michelle Jimenez | Pediatrics | 19333 Clay Rd, Katy, TX 77449-4001 | 2017-03-31 |
| 1376094193 | Demori Driver | Physician Assistant | 19333 Clay Rd, Katy, TX 77449-4001 | 2016-10-17 |
| 1609229525 | Josue Maldonado Custodio | Pediatrics | 19333 Clay Rd, Katy, TX 77449-4001 | 2016-07-15 |
| 1073999827 | Flor De Maria Vasquez Rivera | Nurse Practitioner | 19333 Clay Rd, Katy, TX 77449 | 2015-08-04 |
| 1124417720 | Luis F Martinez | Counselor | 19333 Clay Rd, Katy, TX 77449-4001 | 2015-01-20 |
| 1588945927 | Ebony R Walker | Nurse Practitioner | 19333 Clay Rd, Katy, TX 77449-4001 | 2011-08-30 |
| 1366690943 | Williams, Williams & Hanks Dba Incentives | Substance Abuse Rehabilitation Facility | 19333 Clay Rd, Katy, TX 77449-4001 | 2008-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454507 | Mariah Maldonado | Behavior Technician | 2502 Providence Point Dr., Katy, TX 77449 | 2020-10-12 |
| 1053927863 | Helping Hands Senior Care, LLC | Home Health | 20135 Cable Brook Ln, Katy, TX 77449 | 2020-09-17 |
| 1730706953 | Erliz Jessenia Maldonado | Nurse Practitioner | 3919 N Fry Road, Katy, TX 77449 | 2020-07-03 |
| 1154956225 | Jptx Pllc | Dentist | 3011 West Grand Parkway North, Suite 200, Katy, TX 77449 | 2020-03-09 |
| 1831737345 | Tmd Services LLC | Non-emergency Medical Transport (VAN) | 21022 Iris Bloom Street, Katy, TX 77449 | 2019-12-16 |
| 1558911081 | Samatha Renee Morris | Technician | 27427 Slate Crossing Lane, Katy, TX 77449 | 2019-09-17 |
| 1275188518 | Sanitas Medical Center of Texas Pa | Clinic/Center | 2610 N. Mason Rd, Katy, TX 77449 | 2019-08-05 |
| 1265087472 | Sanitas Medical Center of Texas Pa | Family Medicine | 2610 North Mason Road, Katy, TX 77449 | 2019-08-05 |
| 1255993192 | Chelsea Rae Mitchell | Counselor | 21606 Ivory Gate Ln, Katy, TX 77449 | 2019-07-01 |
| 1376104992 | Vision Republic, Pllc | Optometrist | 23021 Mortan Ranch Rd., Ste D, Katy, TX 77449 | 2019-06-25 |
| Find all providers in zip 77449 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851741003 | Spring Branch Community Health Center | Clinic/Center | 5502 1st St, Katy, TX 77493-2472 | 2016-06-20 |
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| 1780295741 | East Texas Border Health Clinic | Clinic/Center | 705 S Grove St, Marshall, TX 75670-5220 | 2020-08-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.