Provider Demographics
NPI:1215326491
Name:TEJAS HEALTH CARE
Entity type:Organization
Organization Name:TEJAS HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:KEHLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-968-2000
Mailing Address - Street 1:753 E TRAVIS ST
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:TX
Mailing Address - Zip Code:78945-2353
Mailing Address - Country:US
Mailing Address - Phone:979-968-2000
Mailing Address - Fax:979-968-2001
Practice Address - Street 1:185 DECKER DR
Practice Address - Street 2:
Practice Address - City:GIDDINGS
Practice Address - State:TX
Practice Address - Zip Code:78942-1451
Practice Address - Country:US
Practice Address - Phone:979-542-6500
Practice Address - Fax:979-542-1500
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEJAS HEALTH CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-01-12
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)