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Organization

WILLFORD HALL MEDICAL CTR

Active
Other names
LACKLAND PC 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) 292-7970
(210) 292-3722
Mailing address
2200 BERGQUIST DR STE 1, BLDG 4450, LACKLAND AFB, TX 78236-9908
(210) 292-7970
(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
2093037
PK
Enumeration date
09/22/2006
Last updated
03/25/2016
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