Organization
FORT DUNCAN MEDICAL CENTER, L.P.
Active
Other names
FDMC CRNA Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALFREDO ONTIVEROS JR. (CEO/MANAGING DIRECTOR)
(830) 773-5321
Entity
Organization
Contact information
Practice address
350 S ADAMS ST, EAGLE PASS, TX 78852-5110
(830) 773-5321
(830) 758-4872
Mailing address
350 S ADAMS ST, EAGLE PASS, TX 78852-5110
(830) 773-5321
(830) 758-4872
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
722994
TX
146D00000X
Personal Emergency Response Attendant
000547
TX
Other
Enumeration date
05/27/2006
Last updated
09/11/2025
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