# WILFORD HALL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760416614
- **Authorized official:** LYDIA MARTHA CHAPA-WILSON PED NURSE PRACTITION (CYSTIC FIBROSIS/ASTHMA COORDINATOR)
- **Authorized official phone:** (210) 292-7170

## Contact information

- **Practice address:** 2200 BERGQUIST DR STE 1, LACKLAND A F B, TX 78236-9908
- **Practice address phone:** (210) 292-7170
- **Practice address fax:** (210) 292-7209
- **Mailing address:** 2200 BERGQUIST DR STE 1, LACKLAND A F B, TX 78236-9908
- **Mailing address phone:** (210) 292-7170
- **Mailing address fax:** (210) 292-7209

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 286500000X | Military Hospital | 529878 | TX | Yes |

## Other

- **Enumeration date:** 07/10/2006
- **Last updated:** 08/22/2020