BROOKE ARMY MEDICAL CENTER (NPI# 1710532510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710532510 |
| Entity Type | Organization |
| Organization Name | BROOKE ARMY MEDICAL CENTER |
| Practice Address |
7800 W Ih 10 Ste 235 San Antonio TX 78230-4768 |
| Practice Telephone | 2105366650 |
| Practice Fax Number | 2105366180 |
| Mailing Telephone | 2105366650 |
| Mailing Fax Number | 2105366180 |
| Enumeration Date | 2019-08-08 |
| Last Update Date | 2019-08-08 |
| Authorized Official Name | CYNTHIA DE LA CRUZ (MTF SUPPORT) |
| Authorized Official Telephone | 2105366650 |
| Is Organization Subpart | Y |
| Parent Organization Name | BROOKE ARMY MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| DoD OVERSEAS ePhcy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 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 |
7800 W IH 10 STE 235 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78230-4768 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184224834 | Natasha Bakunda | Nurse Practitioner | Fountainhead One Tower, 8200 Ih-10 West, Ste 317, San Antonio, TX 78230 | 2020-10-30 |
| 1154930568 | James Cory Vasquez | Pharmacist | 9900 Wurzbach Road, San Antonio, TX 78230 | 2020-07-31 |
| 1861033144 | Aspasia Amtsberg | Licensed Practical Nurse | 7710 W I-10, San Antonio, TX 78230 | 2019-10-08 |
| 1841840212 | Allison Danielle Davidson | Licensed Vocational Nurse | 7710 West, I-10, San Antonio, TX 78230 | 2019-09-17 |
| 1063062800 | Dalisa Kelly Bacon | Nurse's Aide | 7710 West I 10, San Antonio, TX 78230 | 2019-09-13 |
| 1952878134 | Yvette Turner | Licensed Practical Nurse | 4951 Woodstone Dr, Apt 615 Face 2, San Antonio, TX 78230 | 2018-10-25 |
| 1396226270 | Tammy Lynn Saldana | Registered Nurse | 7710 W I10, San Antonio, TX 78230 | 2018-08-28 |
| 1891275699 | Nina Lum Fru Baumgarten | Counselor | 7710 W1h 10, San Antonio, TX 78230 | 2018-08-21 |
| 1952880833 | Rebecca N Khorram | Speech-Language Pathologist | I-10 W 10609 Frontage Rd, 105, San Antonio, TX 78230 | 2018-08-10 |
| 1770071540 | Michael Allen Kent | Counselor | Northwest Atrium, 11550 West I-10, Suite 235, San Antonio, TX 78230 | 2018-04-27 |
| Find all providers in zip 78230 | ||||
| Taxonomy Code | 332000000X |
| Grouping | Suppliers |
| Classification | Military/U.S. Coast Guard Pharmacy |
| A Department of Defense (DoD) or U.S. Coast Guard entity whose primary function is to store, prepare and dispense pharmaceuticals and other associated items to Uniformed Services beneficiaries. These pharmacies may be associated with a DoD or U.S. Coast Guard clinic, DoD Hospital or freestanding. Usually associated with outpatient services. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: new; 7/1/2006: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508364258 | Wilford Hall Medical Center | Military/U.S. Coast Guard Pharmacy | 25615 Us Highway 281 N Ste 215, San Antonio, TX 78258-7135 | 2018-01-29 |
| 1902117187 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | 1300 Schofield Rd, Bldg 1179, San Antonio, TX 78234 | 2010-06-23 |
| 1144329269 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | 5026, Camp Bullis Rd, San Antonio, TX 78257 | 2006-09-22 |
| 1457742785 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | 10010 Rogers Run, San Antonio, TX 78251-4403 | 2015-02-09 |
| 1538251764 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | 3551 Roger Brooke Dr, San Antonio, TX 78234 | 2006-09-28 |
| 1093814246 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | 3551 Roger Brooke Dr, San Antonio, TX 78234-4504 | 2006-09-22 |
| 1902905052 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | 3551 Roger Brooke Dr, San Antonio, TX 78234-4513 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1124431317 | Carl R. Darnall Army Medical Center | Military/U.S. Coast Guard Pharmacy | 4250 Clear Creek Rd, Room 406, Fort Hood, TX 76544-5095 | 2014-06-05 |
| 1134479413 | William Beaumont Army Medical Center | Military/U.S. Coast Guard Pharmacy | Torch St Rm C101, Bldg 21227, Ft Bliss, TX 79916 | 2012-09-14 |
| 1053618546 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | 6501 Fm 3009, Suite 210, Schertz, TX 78154 | 2011-02-17 |
| 1740580125 | Carl R Darnall Army Medical Center | Military/U.S. Coast Guard Pharmacy | 458 W Highway 190, Town Square Shopping Center, Copperas Cove, TX 76522-3904 | 2010-11-01 |
| 1477853851 | Carl R Darnall Army Medical Center | Military/U.S. Coast Guard Pharmacy | Market Heights Shopping Center 201 E., Central Texas Expressway, Harker Heights, TX 76548 | 2010-11-01 |
| 1891003000 | Carl R Darnall Amry Medical Center | Military/U.S. Coast Guard Pharmacy | 2245 761st Tank Bn, Bldg 2245, Fort Hood, TX 76544 | 2010-09-22 |
| 1962718726 | William Beaumont Army Medical Center | Military/U.S. Coast Guard Pharmacy | Haan Rd, Ste A-11 Bldg 1611, Ft Bliss, TX 79916 | 2010-08-31 |
| 1306160973 | 359th Mdg | Military/U.S. Coast Guard Pharmacy | 630 3rd St W, Bldg 1068, Randolph Afb, TX 78150-4804 | 2010-03-25 |
| 1083842967 | Carl R Darnall Army Medical Center | Military/U.S. Coast Guard Pharmacy | 56501 Headquarters Road, Ft Hood, TX 76544-4791 | 2009-06-30 |
| Find all providers with the same taxonomy | ||||
| City | SAN ANTONIO |
| Zip Code | 78230 |
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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.