# BRANCH MEDICAL CLINIC FT WORTH

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NAVAL HEALTH CLINIC CORPUS CHRISTI
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1114986932
- **Legal business name:** NAVAL HEALTH CLINIC CORPUS CHRISTI
- **Authorized official:** WILLIAM M CONDON (BUMED UBO)
- **Authorized official phone:** (240) 401-3643

## Contact information

- **Practice address:** 1711 DOOLITTLE AVE, NAVAL AIR STATION/ JRB, TX 76127
- **Practice address phone:** (361) 961-6079
- **Practice address fax:** (361) 961-2611
- **Mailing address:** 1711 DOOLITTLE AVE, NAVAL AIR STATION/ JRB, TX 76127-1133
- **Mailing address phone:** (361) 961-6079
- **Mailing address fax:** (361) 961-2611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1100X | Military/U.S. Coast Guard Outpatient Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/21/2006
- **Last updated:** 05/25/2018