Provider Demographics
NPI:1386238624
Name:NORTH CENTRAL TEXAS COMMUNITY HEALTH CARE CENTER INC
Entity type:Organization
Organization Name:NORTH CENTRAL TEXAS COMMUNITY HEALTH CARE CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MINNIX
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:940-766-6306
Mailing Address - Street 1:200 MLK JR BLVD
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-1152
Mailing Address - Country:US
Mailing Address - Phone:940-766-6306
Mailing Address - Fax:940-766-6504
Practice Address - Street 1:4301 COLLEGE DR RM 600
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:TX
Practice Address - Zip Code:76384-3169
Practice Address - Country:US
Practice Address - Phone:940-766-6306
Practice Address - Fax:940-766-6504
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH CENTRAL TEXAS COMMUNITY HEALTH CARE CENTER INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)