Organization
WILLIAM BEAUMONT ARMY MEDICAL CENTER
Active
Parent organization
WILLIAM BEAUMONT ARMY MEDICAL CENTER
Other names
Senior Leader Sustainment USASMA
Organization subpart
Yes
Provider details
NPI number
Legal business name
WILLIAM BEAUMONT ARMY MEDICAL CENTER
Authorized official
NATIVIDAD GONZALEZ (MEDICAL SERVICES ACCOUNTS OFFICER)
(915) 742-2753
Entity
Organization
Contact information
Practice address
11291 SGT E CHURCHILL ST, FORT BLISS, TX 79918-8001
(915) 742-6199
Mailing address
5005 N PIEDRAS ST, ATTN TREASURER'S OFFICE, EL PASO, TX 79920-5001
(915) 742-6199
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295838787
PARENT FACILITY WILLIAM BEAUMONT AMC NPI
—
Enumeration date
08/13/2018
Last updated
11/08/2024
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