Healthcare Provider Details
I. General information
NPI: 1649683400
Provider Name (Legal Business Name): AMC BAMC-FSH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2014
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3551 ROGER BROOKE DR
FORT SAM HOUSTON TX
78234
US
IV. Provider business mailing address
BROOKE ARMY MEDICAL CENTER 3551 ROGER BROOKE DR MCHE-ZAR-UT 201
FORT SAM HOUSTON TX
78234-4513
US
V. Phone/Fax
- Phone: 210-916-6036
- Fax: 210-539-4000
- Phone: 210-916-8563
- Fax: 210-295-4851
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 286500000X |
| Taxonomy | Military Hospital |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332000000X |
| Taxonomy | Military/U.S. Coast Guard Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HECTOR
MORALES
Title or Position: DHA POD
Credential:
Phone: 210-536-6118