Organization
SAUSHEC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY PORTER M.D. (PROGRAM DIRECTOR)
(210) 916-6463
Entity
Organization
Contact information
Practice address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(210) 916-6463
Mailing address
1634 VORMIS VW, SAN ANTONIO, TX 78251-5030
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
—
—
Other
Enumeration date
05/24/2014
Last updated
05/24/2014
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