Healthcare Provider Details

I. General information

NPI: 1689087835
Provider Name (Legal Business Name): WILLIAM BEAUMONT ARMY MEDCIAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2014
Last Update Date: 06/05/2014
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

Practice location:
  • Phone: 915-742-2180
  • Fax: 915-742-3238
Mailing address:
  • Phone: 915-742-2180
  • Fax: 915-742-3238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIC J MARPLE
Title or Position: STUDENT IN TRAINING
Credential:
Phone: 915-742-2180