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General NPI Number Information
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NPI Number | 1821421595
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Entity Type | Organization
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Legal Business Name | AMC BAMC-FSH
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Dates
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Enumeration Date | 08/16/2013
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 3051 GARDEN AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78234-7537
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Country | US
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Telephone | 210-916-4141
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Fax |
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Provider Business Mailing Address
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Address Line | 3851 ROGER BROOKE DR MCHE-COU-T DEPT 201
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City | FORT SAM HOUSTON
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State | TX
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Zip | 78234-4501
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Country | US
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Telephone | 210-916-8558
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Fax |
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Authorized Official
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Title or Position | UBO
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Name | CHARON MONIQUE SEYMORE
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Credential |
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Telephone | 210-916-8563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1100X
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Taxonomy Name | Military/U.S. Coast Guard Outpatient Clinic/Center
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License Number |
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License Number State |
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