Healthcare Provider Details

I. General information

NPI: 1902117187
Provider Name (Legal Business Name): AMC BAMC-FSH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2010
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 SCHOFIELD RD BLDG 1179
SAN ANTONIO TX
78234
US

IV. Provider business mailing address

BROOKE ARMY MEDICAL CENTER 3551 ROGER BROOKE DR MCHE-ZAR-UT 201
SAN ANTONIO TX
78234-4513
US

V. Phone/Fax

Practice location:
  • Phone: 210-916-0747
  • Fax:
Mailing address:
  • Phone: 210-916-0747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332000000X
TaxonomyMilitary/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