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  7. NPI Record 1609171149

HOWARD COUNTY COMMUNITY HEALTH CENTER
Complete NPI Record 1609171149
Clinic/Center - Federally Qualified Health Center (FQHC) in Big Spring, TX

NPI Status: Active since January 13, 2011

Contact Information

103 W 11TH ST
BIG SPRING, TX
ZIP 79720
Phone: (432) 517-4557
Fax: (432) 400-1406

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider Other Organization Name
  6. Provider Other Organization Name Type Code
  7. Provider First Line Business Mailing Address
  8. Provider Business Mailing Address City Name
  9. Provider Business Mailing Address State Name
  10. Provider Business Mailing Address Postal Code
  11. Provider Business Mailing Address Country Code If outside U S
  12. Provider Business Mailing Address Telephone Number
  13. Provider Business Mailing Address Fax Number
  14. Provider First Line Business Practice Location Address
  15. Provider Business Practice Location Address City Name
  16. Provider Business Practice Location Address State Name
  17. Provider Business Practice Location Address Postal Code
  18. Provider Business Practice Location Address Country Code If outside U S
  19. Provider Business Practice Location Address Telephone Number
  20. Provider Business Practice Location Address Fax Number
  21. Provider Enumeration Date
  22. Last Update Date
  23. Authorized Official Last Name
  24. Authorized Official First Name
  25. Authorized Official Middle Name
  26. Authorized Official Title or Position
  27. Authorized Official Telephone Number
  28. Healthcare Provider Taxonomy Code 1
  29. Healthcare Provider Primary Taxonomy Switch 1
  30. Other Provider Identifier 1
  31. Other Provider Identifier Type Code 1
  32. Other Provider Identifier State 1
  33. Is Organization Subpart
  34. Authorized Official Credential Text
  35. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1609171149. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1609171149
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider Other Organization Name: HOWARD COUNTY COMMUNITY HEALTH CENTER
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code: 3
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address: 1000 FM 300
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: LEVELLAND
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: TX
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 793366235
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Mailing Address Telephone Number: 8068947842
The telephone number associated with the location address of the provider being identified.
Provider Business Mailing Address Fax Number: 8068943378
The fax number associated with the location address of the provider being identified.
Provider First Line Business Practice Location Address: 103 W 11TH ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: BIG SPRING
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: TX
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 797202913
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider Business Practice Location Address Country Code If outside U S : US
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Business Practice Location Address Telephone Number: 4325174557
Provider Business Practice Location Address Fax Number: 4324001406
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 1/13/2011
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 12/29/2023
The date that a record was last updated or changed.
Authorized Official Last Name: MADURA
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: JUDITH
The first name of the authorized official.
Authorized Official Middle Name: M
The middle name of the authorized official.
Authorized Official Title or Position: CEO
The title or position of the authorized official.
Authorized Official Telephone Number: 8068947842
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 261QF0400X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Other Provider Identifier 1: 281971603
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: TX
Is Organization Subpart: N
Authorized Official Credential Text: MD
NPI Certification Date: 12/29/2023