1134479413 NPI number — WILLIAM BEAUMONT ARMY MEDICAL CENTER

Table of content: (NPI 1134479413)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134479413 NPI number — WILLIAM BEAUMONT ARMY MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAM BEAUMONT ARMY MEDICAL CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134479413
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
WILLIAM BEAUMONT ARMY MEDICAL CTR C/O TREASURERS OFFICE
Provider Second Line Business Mailing Address:
5005 N. PIEDRAS ST
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79920-5001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-221-8274
Provider Business Mailing Address Fax Number:
210-295-2567

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
TORCH ST RM C101
Provider Second Line Business Practice Location Address:
BLDG 21227
Provider Business Practice Location Address City Name:
FT BLISS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-742-2925
Provider Business Practice Location Address Fax Number:
915-569-4488
Provider Enumeration Date:
09/14/2012

Additional Information

Authorized Official

Authorized Official Last Name:
MORALES
Authorized Official First Name:
HECTOR
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF DHA PASS
Authorized Official Telephone Number:
210-536-6650

Provider Taxonomy Codes

  • Taxonomy code: 332000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2136942 . This is a "PK" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com