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Organization
WILLFORD HALL MEDICAL CTR
Active
Organization
WILLFORD HALL MEDICAL CTR
Active
Other names
LACKLAND ER PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
2200 BERGQUIST DR STE 1, BLDG 4450, LACKLAND AFB, TX 78236-9908
(210) 292-5412
(210) 292-3722
Mailing address
2200 BERGQUIST DR STE 1, BLDG 4450, LACKLAND AFB, TX 78236-9908
(210) 292-5412
(210) 292-3722
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2093033
PK
—
Enumeration date
09/22/2006
Last updated
03/25/2016
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