Healthcare Provider Details

I. General information

NPI: 1861223232
Provider Name (Legal Business Name): BIG SPRING VAMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2024
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W VETERANS BLVD
BIG SPRING TX
79720-5566
US

IV. Provider business mailing address

PO BOX 92601
CLEVELAND OH
44101
US

V. Phone/Fax

Practice location:
  • Phone: 615-355-3451
  • Fax: 702-341-3503
Mailing address:
  • Phone: 615-355-3451
  • Fax: 702-341-3503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QV0200X
TaxonomyVA Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERIN DENISE POTTER
Title or Position: NPI TEAM
Credential:
Phone: 202-382-2579