Healthcare Provider Details

I. General information

NPI: 1710061205
Provider Name (Legal Business Name): WILLIAM BEAUMONT ARMY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 07/14/2008
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

7096 CENTURY PLANT DRIVE
EL PASO TX
79912
US

V. Phone/Fax

Practice location:
  • Phone: 915-569-2520
  • Fax:
Mailing address:
  • Phone: 915-217-0719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number536309
License Number StateTX

VIII. Authorized Official

Name: MS. ROSANN MARIE BIERMAN
Title or Position: STAFF ANESTHETISTS
Credential: CRNA
Phone: 915-569-2520