BROOKE ARMY MEDICAL CENTER (NPI# 1619365285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1619365285 |
Entity Type | Organization |
Organization Name | BROOKE ARMY MEDICAL CENTER |
Other Organization Name | CBMH WESTOVER-JB SAN ANTONIO |
Practice Address |
10010 Rogers Run Suite 100 San Antonio TX 78251-4403 |
Mailing Address |
3551 Roger Brooke Dr Mche-cou-t Dept 211 San Antonio TX 78234-4513 |
Practice Telephone | 2109164141 |
Mailing Telephone | 2109168558 |
Enumeration Date | 2015-01-05 |
Last Update Date | 2019-02-08 |
Authorized Official Name | CLENTON BALLARD (UBO MANAGER) |
Authorized Official Telephone | 2109168561 |
Is Organization Subpart | Y |
Parent Organization Name | BROOKE ARMY MEDICAL CENTER |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM1100X |
Clinic/Center Specialization: Military/U.S. Coast Guard Outpatient |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
PARENT FACILITY NPI 2 | 1538251764 | 01 |
Other Name | Type Code |
---|---|
CBMH WESTOVER-JB SAN ANTONIO | Doing Business As Name - Organization |
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 |
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 |
1538268784 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | 3851 Brooke Drive, Ft Sam Houston, TX 78234-6200 | 2006-09-22 |
Street Address |
10010 ROGERS RUN SUITE 100 |
City | SAN ANTONIO |
State | TX |
Zip Code | 78251-4403 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457742785 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | 10010 Rogers Run, San Antonio, TX 78251-4403 | 2015-02-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255930558 | Iyobosasere Ighoroje | Nurse Practitioner | 11212 Tx - 151, San Antonio, TX 78251 | 2020-10-19 |
1528679933 | Michael Medina | Registered Nurse | 1224 Leonard Hunt, San Antonio, TX 78251 | 2020-08-11 |
1528676053 | Calm Spring Dental | Clinic/Center | 11034 W Military Drive, Suite 104, San Antonio, TX 78251 | 2020-07-21 |
1659917169 | Brianna Ashly Garcia | Behavioral Analyst | 3002 Culebra Rd, 105, San Antonio, TX 78251 | 2019-11-19 |
1245892751 | Rodolfo Eloy Zapata | Behavior Technician | 9032 Dugas Rd Apt 118, San Antonio, TX 78251 | 2019-07-03 |
1174188718 | Kesar Family Pllc | Internal Medicine | 3303 Rodgers Road, Suite 250, San Antonio, TX 78251 | 2019-05-09 |
1730657313 | Culebra Meadows Dental Partners Pllc | Dentist | 7895 Culebra Rd., San Antonio, TX 78251 | 2018-11-13 |
1720563299 | San Juanita Villanueva | Specialist/Technologist | 10618 Cat Mountain, San Antonio, TX 78251 | 2018-10-01 |
1316421506 | Westover Hills Primary Care | Family Medicine | 9022 Culebra Rd, Ste 112, San Antonio, TX 78251 | 2018-09-24 |
1649750894 | Alejandro Rodriguez Flores | Physical Therapy Assistant | 9922 Tx-151, San Antonio, TX 78251 | 2018-08-17 |
Find all providers in zip 78251 |
Taxonomy Code | 261QM1100X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Military/U.S. Coast Guard Outpatient |
The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A "fixed" facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. |
Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: title modified, definition added; 7/1/2006 title modified, definition modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548693526 | Brooke Army Medical Center | Clinic/Center | 5410 Mac Williams Rd, Bldg 5026 Camp Bullis, San Antonio, TX 78257 | 2013-08-14 |
1821421595 | Brooke Army Medical Center | Clinic/Center | 3051 Garden Ave, San Antonio, TX 78234-7537 | 2013-08-16 |
1710310578 | Brooke Army Medical Center | Clinic/Center | 3551 Roger Brooke Dr, San Antonio, TX 78234-4504 | 2013-08-15 |
1306041363 | Brooke Army Medical Center | Clinic/Center | 3551 Roger Brooke Dr, San Antonio, TX 78234 | 2007-06-19 |
1912102955 | Brooke Army Medical Center | Clinic/Center | 3051 Garden Ave, Suite 159 Bldg. 1279, San Antonio, TX 78234 | 2007-06-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326527177 | William Beaumont Army Medical Center | Clinic/Center | 11291 Sgt E Churchill St, Fort Bliss, TX 79918-8001 | 2018-08-13 |
1124505359 | Carl R Darnall Army Medical Center | Clinic/Center | 5200 Bunny Trail, Killeen, TX 76549 | 2018-07-20 |
1568948933 | Carl R Darnall Army Medical Center | Clinic/Center | 415 31st and 761st Tank Battalion, Fort Hood, TX 76544 | 2018-07-18 |
1740766112 | Carl R Darnall Army Medical Center | Clinic/Center | Bldg 2255 52nd and 761st Tank Battalion, Fort Hood, TX 76544 | 2018-07-18 |
1396119681 | Brooke Army Medical Center | Clinic/Center | 2407 N New Braunfels, Bldg 147, Ft Sam Houston, TX 78234 | 2015-11-24 |
1932595204 | Carl R Darnall Army Medical Center | Clinic/Center | 9410 19th St, Fort Hood, TX 76544 | 2015-04-13 |
1154717650 | Carl R Darnall Army Medical Center | Clinic/Center | 31002 74th Street, Fort Hood, TX 76544 | 2015-04-10 |
1073909578 | Carl R Darnall Army Medical Center | Clinic/Center | 37016 77th Street, Fort Hood, TX 76544 | 2015-04-10 |
1972999472 | Carl R Darnall Army Medical Center | Clinic/Center | 24001 Battalion Ave, 58th and 62nd Streets, Fort Hood, TX 76544 | 2015-04-10 |
1629322144 | William Beaumont Army Medical Center | Clinic/Center | Torch St Bldg 21227, Dental Clinic, Fort Bliss, TX 79916 | 2012-11-06 |
Find all providers with the same taxonomy |
City | SAN ANTONIO |
Zip Code | 78251 |
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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.