NPI 1043416878

U.S. Air Force

Organisation Military Hospital San Antonio, TX

Practice location

Address: Whmc Ge 2200 Bergquist Dr STE 1 Lackland Afb, San Antonio, TX 78236-5300
Phone: (210) 292-5875
Fax: (210) 292-5844
Mailing address: 13807 Riverbank Pass, Helotes, TX 78023-3638

Authorised official

Name: Charles Justin Haggerty
Title: Ortho Resident
Phone: (210) 292-5875

Registered specialties

Military Hospital Primary

Hospitals Taxonomy 286500000X Licence 01060712A (IN)

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Registry record

NPI: 1043416878
Entity type: Organization
NPI issued: 27 Jun 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.