# FORT DUNCAN MEDICAL CENTER, L.P.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FDMC CRNA Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194772186
- **Authorized official:** MR. ALFREDO ONTIVEROS JR. (CEO/MANAGING DIRECTOR)
- **Authorized official phone:** (830) 773-5321

## Contact information

- **Practice address:** 350 S ADAMS ST, EAGLE PASS, TX 78852-5110
- **Practice address phone:** (830) 773-5321
- **Practice address fax:** (830) 758-4872
- **Mailing address:** 350 S ADAMS ST, EAGLE PASS, TX 78852-5110
- **Mailing address phone:** (830) 773-5321
- **Mailing address fax:** (830) 758-4872

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133NN1002X | Nutrition Education Nutritionist | 722994 | TX | Yes |
| 146D00000X | Personal Emergency Response Attendant | 000547 | TX | — |

## Other

- **Enumeration date:** 05/27/2006
- **Last updated:** 09/11/2025