| Gonzales Healthcare Systems | |
|
1110 N Sarah Dewitt Dr Gonzales TX 78629-3311 | |
| (830) 672-7581 | |
| (830) 672-2401 |
| Full Name | Gonzales Healthcare Systems |
|---|---|
| Speciality | Clinic/Center |
| Location | 1110 N Sarah Dewitt Dr, Gonzales, Texas |
| Authorized Official Name and Position | Brandon Anzaldua (CEO ADMINISTRATOR) |
| Authorized Official Contact | 8306727581 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gonzales Healthcare Systems Po Box 587 Gonzales TX 78629-0587 Ph: (830) 672-7581 | Gonzales Healthcare Systems 1110 N Sarah Dewitt Dr Gonzales TX 78629-3311 Ph: (830) 672-7581 |
| NPI Number | 1013916287 |
|---|---|
| Provider Enumeration Date | 07/19/2005 |
| Last Update Date | 07/23/2025 |
| Medicare PECOS PAC ID | 8527963776 |
|---|---|
| Medicare Enrollment ID | O20040316001074 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013916287 | NPI | - | NPPES |
| 130781102 | Medicaid | TX | |
| 130781104 | Medicaid | TX | |
| 130781103 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 000130 (Texas) | Secondary |
| 208000000X | Pediatrics | 000103 (Texas) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (Texas) | Primary |
| Provider Name | Jennifer S Farris |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1548220270 PECOS PAC ID: 4284616749 Enrollment ID: I20040607001137 |
| Provider Name | Brandon Stroh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841293628 PECOS PAC ID: 8224073838 Enrollment ID: I20050623000959 |
| Provider Name | Humberto J Rivas |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376547919 PECOS PAC ID: 9638101579 Enrollment ID: I20050831000543 |
| Provider Name | Lisa D Henderson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003898446 PECOS PAC ID: 7315957693 Enrollment ID: I20060502000091 |
| Provider Name | Christopher L Walker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326225822 PECOS PAC ID: 5991875817 Enrollment ID: I20080604000579 |
| Provider Name | John W Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881857498 PECOS PAC ID: 1456426816 Enrollment ID: I20080906000042 |
| Provider Name | Commie Hisey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730181421 PECOS PAC ID: 7113052069 Enrollment ID: I20100317000168 |
| Provider Name | David Meredith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427041383 PECOS PAC ID: 0648305599 Enrollment ID: I20100317000195 |
| Provider Name | Gloria G Box |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386628246 PECOS PAC ID: 9335242114 Enrollment ID: I20100527000063 |
| Provider Name | Alyson J Kirchner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295918266 PECOS PAC ID: 0749312536 Enrollment ID: I20100714000382 |
| Provider Name | Kathleen Mary Koerner |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1093936171 PECOS PAC ID: 8729149844 Enrollment ID: I20120118000836 |
| Provider Name | Nicole Atack |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1114268158 PECOS PAC ID: 6608012190 Enrollment ID: I20130430000100 |
| Provider Name | Catherine R Carpenter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1255449286 PECOS PAC ID: 3678558822 Enrollment ID: I20140219000288 |
| Provider Name | Sue Hanner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477892206 PECOS PAC ID: 3971806340 Enrollment ID: I20161112000144 |
| Provider Name | Kody Lee Selzer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265894323 PECOS PAC ID: 4385904036 Enrollment ID: I20180129001335 |
| Provider Name | Diana Marie Mikulencak-picha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790283596 PECOS PAC ID: 8527320654 Enrollment ID: I20180329000622 |
| Provider Name | Sean A Hattenbach |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225415359 PECOS PAC ID: 9234437435 Enrollment ID: I20180524001372 |
| Provider Name | Douglas L Best |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659321438 PECOS PAC ID: 9234111675 Enrollment ID: I20181012002027 |
| Provider Name | Heather Brooke Domel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295405371 PECOS PAC ID: 4284032053 Enrollment ID: I20211213001937 |
| Provider Name | Celina D Mccown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942967500 PECOS PAC ID: 7315337938 Enrollment ID: I20211214000348 |
| Provider Name | Bradford S Bennett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609308105 PECOS PAC ID: 6709134083 Enrollment ID: I20230615002915 |
| Provider Name | Olufolajimi O Obembe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164630117 PECOS PAC ID: 7315097367 Enrollment ID: I20240912001270 |
| Provider Name | Amanda Frederick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922839448 PECOS PAC ID: 3476954736 Enrollment ID: I20240917003432 |
| Provider Name | Derik K Kenworthy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861726077 PECOS PAC ID: 5193852077 Enrollment ID: I20240920003617 |
| Provider Name | Steven Larsen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508953555 PECOS PAC ID: 7517965064 Enrollment ID: I20240924001442 |
| Provider Name | John Waddell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629562582 PECOS PAC ID: 1355699075 Enrollment ID: I20240928000249 |
| Provider Name | Kimberly H Wright |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356488605 PECOS PAC ID: 8123159308 Enrollment ID: I20240929000006 |
| Provider Name | Matthew James Sigley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952347270 PECOS PAC ID: 4981872462 Enrollment ID: I20240929000027 |
| Provider Name | Mark L Epstein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730525742 PECOS PAC ID: 9638433857 Enrollment ID: I20241010003676 |
| Provider Name | Joseph Letham |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720583024 PECOS PAC ID: 7214396555 Enrollment ID: I20241013000059 |
| Provider Name | Devamurugan Chandramohan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235166620 PECOS PAC ID: 7810088747 Enrollment ID: I20241013000073 |
| Provider Name | Gautham Kandukuri |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174979462 PECOS PAC ID: 5890086680 Enrollment ID: I20241020000002 |
| Provider Name | Benjamin Yunk |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982100038 PECOS PAC ID: 8729448766 Enrollment ID: I20241020000003 |
| Provider Name | Hassan Massouh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083723969 PECOS PAC ID: 6305815820 Enrollment ID: I20241022003718 |
| Provider Name | Nikhil R Kanthala |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063971380 PECOS PAC ID: 7618202151 Enrollment ID: I20241113000262 |
| Provider Name | Jonathan S Mcdougal |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255866224 PECOS PAC ID: 3375812050 Enrollment ID: I20241115004212 |
| Provider Name | Moayad Tarboush |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841668308 PECOS PAC ID: 6800187196 Enrollment ID: I20241120003303 |
| Provider Name | Daryl Pinedo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609098110 PECOS PAC ID: 3577719673 Enrollment ID: I20241216000038 |
| Provider Name | Yuzhou Liu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386096535 PECOS PAC ID: 4789920067 Enrollment ID: I20250123002654 |
| Provider Name | Tamara Y Carroll |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467741538 PECOS PAC ID: 5698093169 Enrollment ID: I20250123003283 |
Country Clinic Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1308 Saint Louis St Ste B, Gonzales, TX 78629 Phone: 830-857-6884 | |
Community Health Centers Of South Central Texas, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 228 Saint George St, Gonzales, TX 78629 Phone: 830-672-6511 Fax: 830-672-3024 | |
Community Health Centers Of South Central Texas, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 229 St. George Street, Gonzales, TX 78629 Phone: 830-672-6511 Fax: 830-672-3981 |