Organization
BAMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAMONA MONTGOMERY (CHIEF, CREDENTIALS SERVICE)
(210) 916-2460
Entity
Organization
Contact information
Practice address
3851 ROGER BROOKE DR., BAMC-MCHEQD (CREDS), FORT SAM HOUSTON, TX 78218-6200
(210) 916-2460
Mailing address
3851 ROGER BROOKE DR., BAMC-MCHEQD (CREDS), FORT SAM HOUSTON, TX 78218-6200
(210) 916-2460
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
390200000X
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
390200000X
BAMC
TX
Enumeration date
08/24/2010
Last updated
08/24/2010
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