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Organization

7TH MEDGRP-DYESS

Active
Parent organization
7TH MEDGRP-DYESS
Other names
Dyess AFB MTF
Organization subpart
Yes

Provider details

NPI number
Legal business name
7TH MEDGRP-DYESS
Authorized official
JEN LEWANDOWSKI (DHA UBO)
(703) 817-4030
Entity
Organization

Contact information

Practice address
697 LOUISIANA DR, SUITE 1C5, DYESS AFB, TX 79607-1367
(325) 696-4712
Mailing address
697 LOUISIANA DR, SUITE 1C5, DYESS AFB, TX 79607-1367
(325) 696-4712

Taxonomy

Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
261QM1101X
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center
332000000X
Military/U.S. Coast Guard Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4511413
NCPDP
TX
Enumeration date
01/24/2006
Last updated
06/17/2025
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