Healthcare Provider Details
I. General information
NPI: 1497168280
Provider Name (Legal Business Name): WILLIAM BEAUMONT ARMY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2014
Last Update Date: 06/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5005 N PIEDRAS ST
EL PASO TX
79920-5001
US
IV. Provider business mailing address
5005 N PIEDRAS ST
EL PASO TX
79920-5001
US
V. Phone/Fax
- Phone: 915-742-2288
- Fax: 915-742-1931
- Phone: 915-742-2288
- Fax: 915-742-1931
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 286500000X |
| Taxonomy | Military Hospital |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DREW
W
NUTE
Title or Position: STUDENT IN TRAINING
Credential: MD
Phone: 915-742-2288