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General NPI Number Information
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NPI Number | 1467754119
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Entity Type | Organization
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Legal Business Name | AUDIE L MURPHY VA HOSPITAL
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Dates
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Enumeration Date | 12/01/2010
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Last Update Date | 12/01/2010
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Provider Practice Location Address
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Address Line | 139 MANNING DR
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City | SAN ANTONIO
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State | TX
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Zip | 78228-5926
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Country | US
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Telephone | 210-436-7069
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Fax |
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Provider Business Mailing Address
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Address Line | 139 MANNING DR
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City | SAN ANTONIO
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State | TX
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Zip | 78228-5926
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Country | US
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Telephone | 210-436-7069
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Fax |
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Authorized Official
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Title or Position | CHIEF OF STAFF
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Name | DR. JULIEANNE FLYNN
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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 | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 10383
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License Number State | TX
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