Healthcare Provider Details

I. General information

NPI: 1124373360
Provider Name (Legal Business Name): AUDIE L. MURPHY MEMORIAL VA HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2012
Last Update Date: 07/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 MERTON MINTER ST
SAN ANTONIO TX
78229-4404
US

IV. Provider business mailing address

7400 MERTON MINTER ST
SAN ANTONIO TX
78229-4404
US

V. Phone/Fax

Practice location:
  • Phone: 210-617-5300
  • Fax:
Mailing address:
  • Phone: 210-617-5300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2865M2000X
TaxonomyMilitary General Acute Care Hospital
License Number56575
License Number StateTX

VIII. Authorized Official

Name: MR. GEOFFERY GERARD STOKELIN
Title or Position: RRT/STAFF THERAPIST
Credential: BSRC RRT
Phone: 210-617-5300