Organization · Type 2 NPI

Health Center of Southeast Texas

Federally Qualified Health Center (FQHC) · Liberty, TX

NPI number 1043570567 Active

Practice location

1400 N Travis St
Liberty, TX 77575-3138

Call (936) 334-1185 Map

Mailing address

307 N William Barnett Ave
Cleveland, TX 77327-4061

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician	207Q00000X	None listed
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed
Family Nurse Practitioner	363LF0000X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

NPI record

NPI: 1043570567
Entity type: Organization (Type 2)
Issued: May 17, 2012
Last updated: Feb 21, 2024
Status: Active

Other names

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Health Center of Southeast Texas - Liberty · doing business as
Health Center of Southeast Texas - Liberty · doing business as

Authorized official

Mr. Steven Racciato
Executive Director
(281) 592-2224

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1043570567

Health Center of Southeast Texas's National Provider Identifier is 1043570567, issued on May 17, 2012. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Liberty, TX. The record was last updated on Feb 21, 2024.