BROOKE ARMY MEDICAL CENTER (NPI# 1538251764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538251764 |
| Entity Type | Organization |
| Organization Name | BROOKE ARMY MEDICAL CENTER |
| Other Organization Name | SAN ANTONIO MILITARY MEDICAL CENTER-SAMMC |
| Practice Address |
3551 Roger Brooke Dr San Antonio TX 78234 |
| Mailing Address |
3551 Roger Brooke Dr Mche-cou-t, Dept 201 San Antonio TX 78234-4513 |
| Practice Telephone | 2109164682 |
| Mailing Telephone | 2109168558 |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2019-02-08 |
| Authorized Official Name | CLENTON BALLARD (C, UBO) |
| Authorized Official Telephone | 2109168561 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers | ||
| N | 341800000X | Military/U.S. Coast Guard Transport | Transportation Services | ||
| N | 261QM1100X |
Clinic/Center Specialization: Military/U.S. Coast Guard Outpatient |
Ambulatory Health Care Facilities | ||
| N | 261QM1101X |
Clinic/Center Specialization: Military and U.S. Coast Guard Ambulatory Procedure |
Ambulatory Health Care Facilities | ||
| Y | 2865M2000X |
Military Hospital Specialization: Military General Acute Care Hospital |
Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP | 4503884 | 01 | |
| MEDCO | AN2598588 | 01 | |
| TX | BC BS PROVIDER | 35JK | 01 |
| TX | BC/BS PROVIDER NUMBER | HH6041 | 01 |
| Other Name | Type Code |
|---|---|
| SAN ANTONIO MILITARY MEDICAL CENTER-SAMMC | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3851 Roger Brooke Drive, Fort Sam Houston, TX 782346200 | 2109164141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710532510 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | 7800 W Ih 10 Ste 235, San Antonio, TX 78230-4768 | 2019-08-08 |
| 1396119681 | Brooke Army Medical Center | Clinic/Center | 2407 N New Braunfels, Bldg 147, Ft Sam Houston, TX 78234 | 2015-11-24 |
| 1619365285 | Brooke Army Medical Center | Clinic/Center | 10010 Rogers Run, Suite 100, San Antonio, TX 78251-4403 | 2015-01-05 |
| 1831502590 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | 2401 Scott Rd, Brooke Army Medical Center, Fort Sam Houston, TX 78234 | 2014-06-10 |
| 1548693526 | Brooke Army Medical Center | Clinic/Center | 5410 Mac Williams Rd, Bldg 5026 Camp Bullis, San Antonio, TX 78257 | 2013-08-14 |
| 1053618546 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | 6501 Fm 3009, Suite 210, Schertz, TX 78154 | 2011-02-17 |
| 1902117187 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | 1300 Schofield Rd, Bldg 1179, San Antonio, TX 78234 | 2010-06-23 |
| 1164627121 | Brooke Army Medical Center | Clinic/Center | 1960 Stanley Rd, Blvd 2375, Fort Sam Houston, TX 78234-7650 | 2007-06-19 |
| 1073612131 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | Bldg 1279, Garden Road, Ft Sam Houston, TX 78234 | 2006-09-22 |
| 1982703047 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | Bldg 2401, Scott Road, Ft Sam Houston, TX 78234 | 2006-09-22 |
| Street Address |
3551 ROGER BROOKE DR |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649274135 | Craig Mahlon Womeldorph | Internal Medicine | 3551 Roger Brooke Dr, San Antonio Military Medical Center, San Antonio, TX 78234-4504 | 2005-06-13 |
| 1639777139 | Carolina Marcia Delgado | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, San Antonio, TX 78234-4504 | 2020-10-15 |
| 1285232439 | Ngozika Oguamanam | Pharmacist | 3551 Roger Brooke Dr, San Antonio, TX 78234-4504 | 2020-10-10 |
| 1528673100 | Sarah Villalpando | Dietitian, Registered | 3551 Roger Brooke Dr, San Antonio, TX 78234-4504 | 2020-09-10 |
| 1568070357 | Thomas Gerald Baughan II | Nurse Anesthetist, Certified Registered | 3551 Roger Brooke Dr, San Antonio, TX 78234-4504 | 2020-07-17 |
| 1356967186 | Wayne James Blalock | Nurse Anesthetist, Certified Registered | 3551 Roger Brooke Dr, San Antonio, TX 78234-4504 | 2020-06-17 |
| 1619591088 | Candace Alexandra Flagg | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, San Antonio, TX 78234-4504 | 2020-06-02 |
| 1396366530 | Kenneth James Johnson | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, San Antonio, TX 78234-4504 | 2020-04-28 |
| 1346879384 | Jacob Loesche | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, Jbsa-fort Sam Houston, San Antonio, TX 78234-4504 | 2020-04-02 |
| 1851927560 | Jarrod Paul Odom | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, San Antonio, TX 78234-4504 | 2020-03-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255942884 | Thomas Ballas | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Drive Jbsa-fort Sam Houston, Department of Behavioral Medicine-mche-dbm, San Antonio, TX 78234 | 2020-08-17 |
| 1124657366 | Wendy Harris | Pharmacist | 3041 Garden Ave, Fort Sam Houston, TX 78234 | 2020-04-08 |
| 1215564729 | Travis Frantz | Student in an Organized Health Care Education/Training Program | 3551 Rodger Brooke Drive, Jbsa Fort Sam Houston, TX 78234 | 2020-03-25 |
| 1508492695 | Matthew Grossmann | Student in an Organized Health Care Education/Training Program | San Antonio Military Medical Center, Mche-zdm-m, Internal Medicine Residency, 3551 Roger Brooke Dr., Jbsa-fort Sam Houston, TX 78234 | 2020-03-20 |
| 1235793407 | Jessica Maria May Franklin | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Drive Jbsa Fort Sam Houston, San Antonio, TX 78234 | 2019-04-23 |
| 1730663477 | Glen Snyder | Military Health Care Provider | 3488 Garden Ave Anderson Hall, Fort Sam Houston, San Antonio, TX 78234 | 2018-09-19 |
| 1265919336 | Ashley Elizabeth Malawey | Military Health Care Provider | 3222 Cpl Johnson Road, San Antonio, TX 78234 | 2018-07-23 |
| 1053805515 | Rene Espinosa | Social Worker | San Antonio Medical Center, 3551 Roger Brooke Dr, Jbsa, TX 78234 | 2018-06-19 |
| 1235622333 | Melanie Edith Rivera | Military Health Care Provider | 3600 Roger Brooke Drive, San Antonio, TX 78234 | 2018-06-13 |
| 1063909158 | Benjamin Walker Appelo | General Practice | San Antonio Mil Med Center 3551 Roger Brooke Dr, Mche-zdm-m, San Antonio, TX 78234 | 2018-04-16 |
| Find all providers in zip 78234 | ||||
| Taxonomy Code | 2865M2000X |
| Grouping | Hospitals |
| Classification | Military Hospital |
| Specialization | Military General Acute Care Hospital |
| A Department of Defense (DoD) health care organization furnishing inpatient care 24 hours per day in "fixed" facilities, primarily for DoD beneficiaries. Entity is Defense Health Program (DHP) funded. A "fixed" facility is a non-temporary, non-deployed facility usually used for health care services. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes those services and institutional costs usually included in a Diagnosis Related Group as well as "pass-through" items. |
| Notes: [1/1/2005: title modified, definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700167632 | Margarita B Mcavay | Military Hospital | 7331 Windbridge, San Antonio, TX 78250-3137 | 2011-09-06 |
| 1144323650 | Wilford Hall Medical Center | Military Hospital | 18200 Blanco Spgs Apt 112, San Antonio, TX 78258-4562 | 2006-09-07 |
| 1124373360 | Audie L. Murphy Memorial Va Hospital | Military Hospital | 7400 Merton Minter St, San Antonio, TX 78229-4404 | 2012-07-13 |
| 1316235955 | United States Navy | Military Hospital | 3837 Binz Engleman Rd, San Antonio, TX 78219-2219 | 2011-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952732398 | Shauna Jones | Military Hospital | 4504 Bronzeway, Dallas, TX 75236 | 2013-12-11 |
| 1790921401 | Michael E. Debakey Veterans Affairs | Military Hospital | 10434 Huntington Wood Dr, Houston, TX 77099-3722 | 2008-12-30 |
| 1952568776 | Vhactx | Military Hospital | 332 Peanut Dr, Temple, TX 76502-5289 | 2008-05-20 |
| 1558747931 | United States Army | Military Hospital | 5005 N Piedras St, El Paso, TX 79920-5002 | 2015-08-07 |
| 1043618531 | Natacha Miller | Military Hospital | 5005 N Piedras St, El Paso, TX 79920-5002 | 2014-12-15 |
| 1245574656 | Veterans Affairs North Texas Health Care System | Military Hospital | 4500 S Lancaster Rd, Dallas, TX 75216-7167 | 2012-11-26 |
| 1477809200 | Micheal .e. Debaky Medical Center | Military Hospital | 2002 Holcombe Blvd, Houston, TX 77030-4211 | 2012-07-30 |
| 1417212283 | Veterans Affairs North Texas Health Care System | Military Hospital | 4500 S Lancaster Rd, Dallas, TX 75216-7167 | 2012-07-09 |
| 1861753394 | Darnall Army Medical Center | Military Hospital | 36000 Darnall Loop, Fort Hood, TX 76544-5095 | 2012-05-31 |
| 1447413307 | Michael E Debakey Veterens Affairs Medical Center | Military Hospital | 2002 Holcombe Blvd., Houston, TX 77030-4211 | 2008-07-09 |
| Find all providers with the same taxonomy | ||||
| City | SAN ANTONIO |
| Zip Code | 78234 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.