Tyler Women and Childrens Clinic – Federally Qualified Health Center (FQHC), NPI 1184103285

Tyler Women and Childrens Clinic is a healthcare provider. based in Longview, Texas. specializing in Federally Qualified Health Center (FQHC). The NPI Number for Tyler Women and Childrens Clinic is 1184103285

Main info

Organization
Name
Tyler Women and Childrens Clinic
NPI
1184103285
Phone
(903) 234-0776
Address
PO BOX 2709
Authorized Official
JESSICA ROLDAN CEO
Enumeration Date
9 August 2018
Last Update Date
18 November 2025
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience29
Completeness90
Years active:7State licenses:0Digital endpoints

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Provider Addresses for Tyler Women and Childrens Clinic

  • PO BOX 2709

    LONGVIEW, TX 756062709

    Phone: (903) 234-0776

    Fax: (903) 234-9769

    Type: Mailing

  • 4519, Troup Highway, Tyler, Smith County, Texas, 75703, United States

    TYLER, TX 757032350

    Phone: (903) 289-9252

    Fax: (903) 630-5456

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-10-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-11-30 (925 days ago).

Enrollment records

1

Earliest due date

2023-11-30

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20181016000873OFederally Qualified Health Center (Fqhc)TX2023-11-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 75606)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Tyler Women and Childrens Clinic?
Tyler Women and Childrens Clinic — NPI 1184103285 — is the standard way to identify this listing.
Is Tyler Women and Childrens Clinic listed as active for patients and plans?
The listing shows Tyler Women and Childrens Clinic as active in the NPI system.
What is Tyler Women and Childrens Clinic's primary classification?
Federally Qualified Health Center (FQHC) is the headline specialty for Tyler Women and Childrens Clinic here. Clinical services aligned with this taxonomy classification.
Where should I expect Tyler Women and Childrens Clinic on a map?
Expect Longview, Texas as a primary anchor for Tyler Women and Childrens Clinic unless the record lists multiple sites.
Why does Tyler Women and Childrens Clinic have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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