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General NPI Number Information
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NPI Number | 1124121462
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Entity Type | Organization
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Legal Business Name | AUDIE L MURPHY MEMORIAL VA HOSPTIAL
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5788 ECKHERT RD.
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City | SAN ANTONIO
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State | TX
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Zip | 78240
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Country | US
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Telephone | 210-699-2158
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Fax | 210-699-2257
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Provider Business Mailing Address
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Address Line | 5788 ECKHERT RD
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City | SAN ANTONIO
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State | TX
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Zip | 78240-3900
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Country | US
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Telephone | 210-699-2158
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. TIM SHEA
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Credential |
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Telephone | 210-617-5300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | SO3648
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License Number State | TX
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