Healthcare Provider Details

I. General information

NPI: 1689121006
Provider Name (Legal Business Name): CARL DARNALL ARMY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 09/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARL DARNALL ARMY MEDICAL CENTER 36065 SANTE FE AVE
APO AA
76544-9997
US

IV. Provider business mailing address

CARL DARNALL ARMY MEDICAL CENTER 36065 SANTE FE AVE FORT HOOD, TEXAS
APO AA
76544-9997
US

V. Phone/Fax

Practice location:
  • Phone: 254-553-5319
  • Fax:
Mailing address:
  • Phone: 254-553-5319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number0102204108
License Number StateVA

VIII. Authorized Official

Name: DORIAN ANDERSON
Title or Position: INTERNAL MEDICINE STAFF PHYSICIAN
Credential: D.O
Phone: 936-443-4804