Liabilities / Assets
Score unavailable
Liabilities-to-assets requires both liabilities and assets on the latest valid filing.
EIN 27-1056537 • 501(c)3 • Austin, TX
Profile
Facilitate the delivery of health care services to indigent persons in galveston county, texas. The corporation does not bill or collect any fees for care provided to the indigent. All revenue comes from payments from the members.
Refreshing map…
Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.
Liabilities / Assets
Score unavailable
Liabilities-to-assets requires both liabilities and assets on the latest valid filing.
Liabilities / Revenue
Score unavailable
Liabilities-to-revenue requires both liabilities and revenue on the latest valid filing.
Net Margin
Score unavailable
Net margin requires both revenue and expenses on the latest valid filing.
Top Officer Pay
81st percentile
Higher top officer pay than 81% of similar nonprofits.
Asset Growth
10th percentile
Faster asset growth than 10% of similar nonprofits.
Revenue Growth
3rd percentile
Faster revenue growth than 3% of similar nonprofits.
Assets
Down$0
Down $44,240 (-100%) from 2020
Liabilities
Down$0
Down $867 (-100%) from 2020
Net Assets
Down$0
Down $43,373 (-100%) from 2020
Revenue
Down$0
Down $901,580 (-100%) from 2020
Expenses
Down$43,373
Down $562,808 (-93%) from 2020
Net Income
Down-$43,373
Down $338,772 (-115%) from 2020
Most recent year
2021 • Form 990Facts available. Structured filing facts are available, but richer extracted sections are limited.
| Balance Sheet | Operations | |||||
|---|---|---|---|---|---|---|
| Year | Assets | Liabilities | Net Assets | Revenue | Expenses | Net Income |
| 2021Facts available. Structured filing facts are available, but richer extracted sections are limited. | $0.00 | $0.00 | $0.00 | $0.00 | $0.43 | $0.43 |
| 2020Facts available. Structured filing facts are available, but richer extracted sections are limited. | $0.44 | $0.01 | $0.43 | $9.02 | $6.06 | $2.95 |
Facilitate the delivery of health care services to indigent persons in galveston county, texas. The corporation does not bill or collect any fees for care provided to the indigent. All revenue comes from payments from the members.
Facilitate the delivery of health care services to indigent persons in galveston county, tx. The corporation does not bill or collect any fees for care provided to the indigent.
| Line | Beginning | End | Change |
|---|---|---|---|
| Assets | |||
| Accounts Receivable | $44,233 | $0 | ▼ $44,233 |
| Cash and Non-Interest-Bearing Accounts | $7 | $0 | ▼ $7 |
| Savings and Temporary Cash Investments | $0 | $0 | → $0 |
| Other Notes and Loans Receivable, Net | $0 | $0 | → $0 |
| Pledges and Grants Receivable | $0 | $0 | → $0 |
| Receivable From Disqualified Prsn | $0 | $0 | → $0 |
| Receivables From Officers Etc | $0 | $0 | → $0 |
| Investments Other Securities | $0 | $0 | → $0 |
| Investments Program Related | $0 | $0 | → $0 |
| Investments in Publicly Traded Securities | $0 | $0 | → $0 |
| Land, Buildings, and Equipment, Net | $0 | $0 | → $0 |
| Intangible Assets | $0 | $0 | → $0 |
| Inventories for Sale or Use | $0 | $0 | → $0 |
| Loans From Officers Directors | $0 | $0 | → $0 |
| Prepaid Expenses and Deferred Charges | $0 | $0 | → $0 |
| Total Assets | $44,240 | $0 | ▼ $44,240 |
| Other Assets Total | $0 | $0 | → $0 |
| Liabilities | |||
| Accounts Payable and Accrued Expenses | $867 | $0 | ▼ $867 |
| Grants Payable | $0 | $0 | → $0 |
| Mortgage Notes Payable Secured by Investment Property | $0 | $0 | → $0 |
| Unsecured Notes Loans Payable | $0 | $0 | → $0 |
| Other Liabilities | $0 | $0 | → $0 |
| Deferred Revenue | $0 | $0 | → $0 |
| Escrow Account Liability | $0 | $0 | → $0 |
| Tax Exempt Bond Liabilities | $0 | $0 | → $0 |
| Total Liabilities | $867 | $0 | ▼ $867 |
| Net Assets / Fund Balance | |||
| Net Assets Without Donor Restrictions | $43,373 | $0 | ▼ $43,373 |
| Net Assets With Donor Restrictions | $0 | $0 | → $0 |
| Total Net Assets Fund Balance | $43,373 | $0 | ▼ $43,373 |
| Total Liabilities and Net Assets / Fund Balance | $44,240 | $0 | ▼ $44,240 |
| Name | Title |
|---|---|
| Troy Villarreal | President |
| Carl Vartian Md | Director |
| Mujtaba Ali-kahn Md | Director |
| Augusto Sepulveda Md | Director (12/8/20-8/31/21) |
| Stephen Nesbit Do | Director (9/1/20-12/8/20) |
| Jeff Sliwinski | Secretary |
| Line Item | Amount |
|---|---|
| Other Expenses | $43,373 |
| Grants and Similar Amounts Paid | $0 |
| Professional Fundraising Fees | $0 |
| Salaries, Compensation, and Employee Benefits | $0 |
| Total Fundraising Expense | $0 |
| Line Item | Program | Management | Fundraising | Total |
|---|---|---|---|---|
| Other Expenses | $43,373 | - | - | $43,373 |
| Total Functional Expenses | $43,373 | $0 | $0 | $43,373 |
| Line Item | Amount |
|---|---|
| Fundraising Direct Expenses | $0 |
| Fundraising Gross Income | $0 |
| Gaming Direct Expenses | $0 |
| Gaming Gross Income | $0 |
| Professional Fundraising Fees | $0 |
| Line Item | Beginning | End | Change |
|---|---|---|---|
| Loans from Officers, Directors, Trustees, and Key Employees | $0 | $0 | → $0 |
| Receivables from Disqualified Persons | $0 | $0 | → $0 |
| Receivables from Officers, Directors, Trustees, and Key Employees | $0 | $0 | → $0 |
“The corporation's directors are or have been either employed or have medical staff privileges, at the corporation's member or at an organization affiliated with the member of the corporation. The corporation's officers are officers of the corporation's member.”
“SECTION A. GOVERNING BODY AND MANAGEMENT THE MEMBER ACTS AS THE GOVERNING BODY OF THE CORPORATION AND CONTROLS THE FINANCIAL ASPECTS OF THE CORPORATION. ITEM 2 - THE CORPORATION'S DIRECTORS ARE OR HAVE BEEN EITHER EMPLOYED OR HAVE MEDICAL STAFF PRIVILEGES AT THE CORPORATION'S MEMBER OR AT AN ORGANIZATION AFFILIATED WITH THE MEMBER OF THE CORPORATION. ITEM 6 - THE CORPORATION IS ORGANIZED AS A MEMBER CORPORATION UNDER TEXAS LAW AND HAS ONE MEMBER. THIS MEMBER APPOINTS THE DIRECTORS OF THE CORPORATION AND THE OFFICERS. EACH DIRECTOR AND SUCCESSOR DIRECTOR SHALL AT ALL TIMES BE A PHYSICIAN DULY LICENSED TO PRACTICE MEDICINE BY THE TEXAS MEDICAL BOARD AND ACTIVELY ENGAGED IN THE PRACTICE OF MEDICINE AND SHALL HAVE, OR SATISFY, SUCH OTHER QUALIFICATIONS AS MAY BE SET FORTH IN THE BYLAWS OF THE CORPORATION. ITEM 7a - NO PERSON SHALL BECOME A MEMBER OF THE CORPORATION WITHOUT THE UNANIMOUS VOTE OF THE THEN CURRENT MEMBERS. ITEM 7b - THE DECISIONS OF THE MEMBER WITH RESPECT TO THE TERMINATION OR THE RETENTION OF A PHYSICIAN TO PROVIDE MEDICAL SERVICES ARE SUBJECT TO THE APPROVAL OF THE BOARD OF DIRECTORS. ITEM 8b - THE CORPORATION HAS NO COMMITTEES AUTHORIZED TO ACT ON BEHALF OF THE GOVERNING BODY. ITEM 9 - OFFICER AND DIRECTOR ADDRESSES Officers: TROY VILLARREAL, PRESIDENT 3737 BUFFALO SPEEDWAY, SUITE 1400 HOUSTON, TX 77098 JEFF SLIWINSKI, SECRETARY 3737 BUFFALO SPEEDWAY, SUITE 1400 HOUSTON, TX 77098 Directors: STEPHEN NESBIT, D.O. (9/1/2020-12/8/2020) 3737 BUFFALO SPEEDWAY, SUITE 1400 HOUSTON, TX 77098 AUGUSTO SEPULVEDA, M.D.(12/8/2020-8/31/2021) 3737 BUFFALO SPEEDWAY, SUITE 1400 HOUSTON, TX 77098 CARL VARTIAN, M.D. 7777 SOUTHWEST FWY., SUITE 740 HOUSTON, TX 77074 MUJTABA ALI-KAHN, M.D. 22999 US HWY 59 N. KNIGWOOD, TX 77339 SECTION B. POLICIES ITEM 11 - A COPY OF THE FORM 990 WAS PROVIDED TO THE MEMBER FOR REVIEW PRIOR TO FILING. LINE 12b - CONSISTENT WITH THE REQUIREMENTS OF THE TEXAS MEDICAL BOARD, THE DIRECTORS DISCLOSE INTERESTS BIENNIALLY. LINE 12c - BEFORE ENTERING ANY CONTRACTUAL OBLIGATIONS, THE CORPORATION'S OBLIGATIONS ARE REVIEWED BY OUTSIDE COUNSEL FOR CONFLICTS OF INTEREST. SECTION C. DISCLOSURE LINE 19 - THE CORPORATION PROVIDES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY UPON REQUEST.”
“The organization utilizes the services of the third-party administrator(tpa) listed below to process payments made to the providers of healthcare services to the organization. The tpa reported payments made on behalf of the organization to vendors on form 1099-misc issued under the tpa's federal identification number for the calendar year december 31, 2020. Boon-chapman 2 waterway avenue, suite 650 the woodlands, tx 77380”
“Line 3, the organization ceased conducting or made significant changes in how it conducts its program services: effective on 02/01/2020, galveston county clinical services, inc assigned all service contracts to galveston county. Galveston county clinical services, inc has not renewed contracts for services and will not be entering into any new contracts.”
This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.
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| IRS990/Desc | 0 | FACILITATE THE DELIVERY OF HEALTH CARE SERVICES TO INDIGENT PERSONS IN GALVESTON COUNTY, TEXAS. THE CORPORATION DOES NOT BILL OR COLLECT ANY FUNDS FOR CARE PROVIDED TO THE INDIGENT. ALL REVENUE COMES FROM PAYMENTS FROM THE MEMBERS. |
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| IRS990/Form990PartVIISectionAGrp/TitleTxt | 4 | Secretary |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 5 | PRESIDENT |
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| IRS990/PledgesAndGrantsReceivableGrp/EOYAmt | 0 | 0 |
| IRS990/PoliticalCampaignActyInd | 0 | false |
| IRS990/PrepaidExpensesDefrdChargesGrp/BOYAmt | 0 | 0 |
| IRS990/PrepaidExpensesDefrdChargesGrp/EOYAmt | 0 | 0 |
| IRS990/PrincipalOfficerNm | 0 | TROY VILLARREAL PRESIDENT |
| IRS990/ProfessionalFundraisingInd | 0 | false |
| IRS990/ProhibitedTaxShelterTransInd | 0 | false |
| IRS990/PYBenefitsPaidToMembersAmt | 0 | 0 |
| IRS990/PYContributionsGrantsAmt | 0 | 0 |
| IRS990/PYExcessBenefitTransInd | 0 | false |
| IRS990/PYGrantsAndSimilarPaidAmt | 0 | 0 |
| IRS990/PYInvestmentIncomeAmt | 0 | 0 |
| IRS990/PymtTravelEntrtnmntPubOfclGrp/TotalAmt | 0 | 0 |
| IRS990/PYOtherExpensesAmt | 0 | 606181 |
| IRS990/PYOtherRevenueAmt | 0 | 0 |
| IRS990/PYProgramServiceRevenueAmt | 0 | 901580 |
| IRS990/PYRevenuesLessExpensesAmt | 0 | 295399 |
| IRS990/PYSalariesCompEmpBnftPaidAmt | 0 | 0 |
| IRS990/PYTotalExpensesAmt | 0 | 606181 |
| IRS990/PYTotalProfFndrsngExpnsAmt | 0 | 0 |
| IRS990/PYTotalRevenueAmt | 0 | 901580 |
| IRS990/QuidProQuoContributionsInd | 0 | false |
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| IRS990/RcvblFromDisqualifiedPrsnGrp/EOYAmt | 0 | 0 |
| IRS990/RcvFndsToPayPrsnlBnftCntrctInd | 0 | false |
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| IRS990/ReceivablesFromOfficersEtcGrp/EOYAmt | 0 | 0 |
| IRS990/ReconcilationRevenueExpnssAmt | 0 | -43373 |
| IRS990/RegularMonitoringEnfrcInd | 0 | true |
| IRS990/RelatedEntityInd | 0 | false |
| IRS990/RelatedOrganizationCtrlEntInd | 0 | false |
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| IRS990/RentalIncomeOrLossGrp/RealAmt | 0 | 0 |
| IRS990/ReportInvestmentsOtherSecInd | 0 | false |
| IRS990/ReportLandBuildingEquipmentInd | 0 | false |
| IRS990/ReportOtherAssetsInd | 0 | false |
| IRS990/ReportOtherLiabilitiesInd | 0 | false |
| IRS990/ReportProgramRelatedInvstInd | 0 | false |
| IRS990/RevenueAmt | 0 | 0 |
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| IRS990/SavingsAndTempCashInvstGrp/BOYAmt | 0 | 0 |
| IRS990/SavingsAndTempCashInvstGrp/EOYAmt | 0 | 0 |
| IRS990ScheduleA/AmountsRcvdDsqlfyPersonGrp/TotalAmt | 0 | 0 |
| IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearAmt | 0 | 0 |
| IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus1YearAmt | 0 | 0 |
| IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus2YearsAmt | 0 | 0 |
| IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus3YearsAmt | 0 | 0 |
| IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus4YearsAmt | 0 | 0 |
| IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/TotalAmt | 0 | 0 |
| IRS990ScheduleA/GovtFurnSrvcFcltsVl509Grp/TotalAmt | 0 | 0 |
| IRS990ScheduleA/GrossInvestmentIncome509Grp/TotalAmt | 0 | 0 |
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| IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus2YearsAmt | 0 | 1323200 |
| IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus3YearsAmt | 0 | 1481200 |
| IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus4YearsAmt | 0 | 1625200 |
| IRS990ScheduleA/GrossReceiptsAdmissionsGrp/TotalAmt | 0 | 5331180 |
| IRS990ScheduleA/GrossReceiptsNonUnrltBusGrp/TotalAmt | 0 | 0 |
| IRS990ScheduleA/InvestmentIncomeAndUBTIGrp/TotalAmt | 0 | 0 |
| IRS990ScheduleA/InvestmentIncomeCYPct | 0 | 0.00000 |
| IRS990ScheduleA/InvestmentIncomePYPct | 0 | 0.00000 |
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| IRS990ScheduleA/OtherIncome509Grp/TotalAmt | 0 | 0 |
| IRS990ScheduleA/Post1975UBTIGrp/TotalAmt | 0 | 0 |
| IRS990ScheduleA/PubliclySupportedOrg509a2Ind | 0 | X |
| IRS990ScheduleA/PublicSupportCY509Pct | 0 | 1.00000 |
| IRS990ScheduleA/PublicSupportPY509Pct | 0 | 1.00000 |
| IRS990ScheduleA/PublicSupportTotal509Amt | 0 | 5331180 |
| IRS990ScheduleA/SubstAndDsqlfyPrsnsTotGrp/TotalAmt | 0 | 0 |
| IRS990ScheduleA/SubstantialContributorsAmtGrp/TotalAmt | 0 | 0 |
| IRS990ScheduleA/TaxRevLeviedOrgnztnlBnft509Grp/TotalAmt | 0 | 0 |
| IRS990ScheduleA/ThirtyThrPctSuprtTestsCY509Ind | 0 | X |
| IRS990ScheduleA/Total509Grp/CurrentTaxYearAmt | 0 | 0 |
| IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus1YearAmt | 0 | 901580 |
| IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus2YearsAmt | 0 | 1323200 |
| IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus3YearsAmt | 0 | 1481200 |
| IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus4YearsAmt | 0 | 1625200 |
| IRS990ScheduleA/Total509Grp/TotalAmt | 0 | 5331180 |
| IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearAmt | 0 | 0 |
| IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus1YearAmt | 0 | 901580 |
| IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus2YearsAmt | 0 | 1323200 |
| IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus3YearsAmt | 0 | 1481200 |
| IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus4YearsAmt | 0 | 1625200 |
| IRS990ScheduleA/TotalSupportCalendarYearGrp/TotalAmt | 0 | 5331180 |
| IRS990/ScheduleBRequiredInd | 0 | false |
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| IRS990ScheduleN/AttorneyGeneralNotifiedInd | 0 | true |
| IRS990ScheduleN/BondsOutstandingInd | 0 | false |
| IRS990ScheduleN/DirectorOfSuccessorInd | 0 | true |
| IRS990ScheduleN/EmployeeOfSuccessorInd | 0 | false |
| IRS990ScheduleN/LiabilitiesPaidInd | 0 | true |
| IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/AssetsDistriOrExpnssPaidDesc | 0 | CASH |
| IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/DistributionDt | 0 | 2021-01-04 |
| IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/EIN | 0 | 273325657 |
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| IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/IRCSectionTxt | 0 | 501(C)(3) |
| IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/MethodOfFMVDeterminationTxt | 0 | CASH |
| IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/PersonNm | 0 | SOUTHERN HEALTHCARE ALLIANCE |
| IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/AddressLine1Txt | 0 | 2801 VIA FORTUNA 500 AustinTx 7 |
| IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/CityNm | 0 | AUSTIN |
| IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/StateAbbreviationCd | 0 | TX |
| IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/ZIPCd | 0 | 787467573 |
| IRS990ScheduleN/OwnerOfSuccessorInd | 0 | false |
| IRS990ScheduleN/ReceiveCompensationInd | 0 | false |
| IRS990ScheduleN/RequiredToNotifyAGInd | 0 | true |
| IRS990ScheduleN/SupplementalInformationDetail/ExplanationTxt | 0 | JEFF SLIWINSKI WAS THE SECRETARY OF GALVESTON COUNTY CLINICAL SERVICES, INC. WHEN IT WAS DISSOLVED. HE IS ALSO THE PRESIDENT AND A DIRECTOR OF SOUTHERN HEALTHCARE ALLIANCE. THE BALANCE OF ENDING CASH $43,372 WAS DONATED BY GALVESTON COUNTY CLINICAL SERVICES, INC. TO SOUTHERN HEALTHCARE ALLIANCE. BOTH ARE 501(C)(3) CHARITIES. JEFF SLIWINSKI RECEIVED NO DIRECT BENEFIT FROM HIS POSITION AS AN OFFICER AND DIRECTOR OF EITHER ORGANIZATION. JEFF SLIWINSKI GULF COAST DIVISION, INC. 3737 BUFFALO SPEEDWAY, SUITE 1400 HOUSTON, TX. 77098 |
| IRS990ScheduleN/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | Form 990 - Schedule N - line 2a |
| IRS990/ScheduleORequiredInd | 0 | true |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 0 | THE CORPORATION'S DIRECTORS ARE OR HAVE BEEN EITHER EMPLOYED OR HAVE MEDICAL STAFF PRIVILEGES, AT THE CORPORATION'S MEMBER OR AT AN ORGANIZATION AFFILIATED WITH THE MEMBER OF THE CORPORATION. THE CORPORATION'S OFFICERS ARE OFFICERS OF THE CORPORATION'S MEMBER. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 1 | SECTION A. GOVERNING BODY AND MANAGEMENT THE MEMBER ACTS AS THE GOVERNING BODY OF THE CORPORATION AND CONTROLS THE FINANCIAL ASPECTS OF THE CORPORATION. ITEM 2 - THE CORPORATION'S DIRECTORS ARE OR HAVE BEEN EITHER EMPLOYED OR HAVE MEDICAL STAFF PRIVILEGES AT THE CORPORATION'S MEMBER OR AT AN ORGANIZATION AFFILIATED WITH THE MEMBER OF THE CORPORATION. ITEM 6 - THE CORPORATION IS ORGANIZED AS A MEMBER CORPORATION UNDER TEXAS LAW AND HAS ONE MEMBER. THIS MEMBER APPOINTS THE DIRECTORS OF THE CORPORATION AND THE OFFICERS. EACH DIRECTOR AND SUCCESSOR DIRECTOR SHALL AT ALL TIMES BE A PHYSICIAN DULY LICENSED TO PRACTICE MEDICINE BY THE TEXAS MEDICAL BOARD AND ACTIVELY ENGAGED IN THE PRACTICE OF MEDICINE AND SHALL HAVE, OR SATISFY, SUCH OTHER QUALIFICATIONS AS MAY BE SET FORTH IN THE BYLAWS OF THE CORPORATION. ITEM 7a - NO PERSON SHALL BECOME A MEMBER OF THE CORPORATION WITHOUT THE UNANIMOUS VOTE OF THE THEN CURRENT MEMBERS. ITEM 7b - THE DECISIONS OF THE MEMBER WITH RESPECT TO THE TERMINATION OR THE RETENTION OF A PHYSICIAN TO PROVIDE MEDICAL SERVICES ARE SUBJECT TO THE APPROVAL OF THE BOARD OF DIRECTORS. ITEM 8b - THE CORPORATION HAS NO COMMITTEES AUTHORIZED TO ACT ON BEHALF OF THE GOVERNING BODY. ITEM 9 - OFFICER AND DIRECTOR ADDRESSES Officers: TROY VILLARREAL, PRESIDENT 3737 BUFFALO SPEEDWAY, SUITE 1400 HOUSTON, TX 77098 JEFF SLIWINSKI, SECRETARY 3737 BUFFALO SPEEDWAY, SUITE 1400 HOUSTON, TX 77098 Directors: STEPHEN NESBIT, D.O. (9/1/2020-12/8/2020) 3737 BUFFALO SPEEDWAY, SUITE 1400 HOUSTON, TX 77098 AUGUSTO SEPULVEDA, M.D.(12/8/2020-8/31/2021) 3737 BUFFALO SPEEDWAY, SUITE 1400 HOUSTON, TX 77098 CARL VARTIAN, M.D. 7777 SOUTHWEST FWY., SUITE 740 HOUSTON, TX 77074 MUJTABA ALI-KAHN, M.D. 22999 US HWY 59 N. KNIGWOOD, TX 77339 SECTION B. POLICIES ITEM 11 - A COPY OF THE FORM 990 WAS PROVIDED TO THE MEMBER FOR REVIEW PRIOR TO FILING. LINE 12b - CONSISTENT WITH THE REQUIREMENTS OF THE TEXAS MEDICAL BOARD, THE DIRECTORS DISCLOSE INTERESTS BIENNIALLY. LINE 12c - BEFORE ENTERING ANY CONTRACTUAL OBLIGATIONS, THE CORPORATION'S OBLIGATIONS ARE REVIEWED BY OUTSIDE COUNSEL FOR CONFLICTS OF INTEREST. SECTION C. DISCLOSURE LINE 19 - THE CORPORATION PROVIDES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY UPON REQUEST. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 2 | THE ORGANIZATION UTILIZES THE SERVICES OF THE THIRD-PARTY ADMINISTRATOR(TPA) LISTED BELOW TO PROCESS PAYMENTS MADE TO THE PROVIDERS OF HEALTHCARE SERVICES TO THE ORGANIZATION. THE TPA REPORTED PAYMENTS MADE ON BEHALF OF THE ORGANIZATION TO VENDORS ON FORM 1099-MISC ISSUED UNDER THE TPA'S FEDERAL IDENTIFICATION NUMBER FOR THE CALENDAR YEAR DECEMBER 31, 2020. BOON-CHAPMAN 2 WATERWAY AVENUE, SUITE 650 THE WOODLANDS, TX 77380 |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 3 | LINE 3, THE ORGANIZATION CEASED CONDUCTING OR MADE SIGNIFICANT CHANGES IN HOW IT CONDUCTS ITS PROGRAM SERVICES: EFFECTIVE ON 02/01/2020, GALVESTON COUNTY CLINICAL SERVICES, INC ASSIGNED ALL SERVICE CONTRACTS TO GALVESTON COUNTY. GALVESTON COUNTY CLINICAL SERVICES, INC HAS NOT RENEWED CONTRACTS FOR SERVICES AND WILL NOT BE ENTERING INTO ANY NEW CONTRACTS. |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | PART VI-OFFICERS, DIRECTORS, OR KEY EMPLOYEE BUSINESS RELATIONSHIPS |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 1 | PART VI - GOVERNANCE, MANAGEMENT AND DISCLOSURES |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 2 | PART VII - COMPENSATION OF INDEPENDENT CONTRACTORS |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 3 | PAGE 2, PART III - STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS |
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| IRS990/SignificantChangeInd | 0 | true |
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| IRS990/SubjectToProxyTaxInd | 0 | false |
| IRS990/SubjToTaxRmnrtnExPrchtPymtInd | 0 | false |
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| IRS990/TotalFunctionalExpensesGrp/TotalAmt | 0 | 43373 |
| IRS990/TotalGrossUBIAmt | 0 | 0 |
| IRS990/TotalLiabilitiesBOYAmt | 0 | 867 |
| IRS990/TotalLiabilitiesEOYAmt | 0 | 0 |
| IRS990/TotalLiabilitiesGrp/BOYAmt | 0 | 867 |
| IRS990/TotalLiabilitiesGrp/EOYAmt | 0 | 0 |
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| IRS990/TotalVolunteersCnt | 0 | 0 |
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| IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt | 0 | 0 |
| IRS990/TotReportableCompRltdOrgAmt | 0 | 0 |
| IRS990/TravelGrp/TotalAmt | 0 | 0 |
| IRS990/TrnsfrExmptNonChrtblRltdOrgInd | 0 | false |
| IRS990/TypeOfOrganizationCorpInd | 0 | X |
| IRS990/UnrelatedBusIncmOverLimitInd | 0 | false |
| IRS990/UnsecuredNotesLoansPayableGrp/BOYAmt | 0 | 0 |
| IRS990/UnsecuredNotesLoansPayableGrp/EOYAmt | 0 | 0 |
| IRS990/UponRequestInd | 0 | X |
| IRS990/USAddress/AddressLine1Txt | 0 | 3737 BUFFALO SPEEDWAYSTE 1400 |
| IRS990/USAddress/CityNm | 0 | HOUSTON |
| IRS990/USAddress/StateAbbreviationCd | 0 | TX |
| IRS990/USAddress/ZIPCd | 0 | 77098 |
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