Organization · Type 2 NPI

William Beaumont Army Medical Center

Military/U.S. Coast Guard Outpatient Clinic/Center · El Paso, TX

NPI number 1104170646 Active

Practice location

10460 Vista Del Sol Dr
El Paso, TX 79925-7947

Call (915) 742-2121 Map

Mailing address

5005 N Piedras St, Attn Treasurer's Office
El Paso, TX 79920-5001

Specialties and licenses

Taxonomy	Code	License
Military/U.S. Coast Guard Outpatient Clinic/Center Primary	261QM1100X	None listed

Military/U.S. Coast Guard Outpatient Clinic/Center: The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A "fixed" facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes, as exam…

2 other providers at this address

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NPI record

NPI: 1104170646
Entity type: Organization (Type 2)
Issued: Nov 6, 2012
Last updated: Jan 7, 2013
Status: Active
Subpart: Yes of William Beaumont Army Medical Center

Other names

<unavail>
Rio Bravo Medical Home-Bliss · doing business as

Authorized official

Jose Cruz-Melendez
Ubo Manager
(915) 742-8291

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104170646

William Beaumont Army Medical Center's National Provider Identifier is 1104170646, issued on Nov 6, 2012. The primary taxonomy on file is Military/U.S. Coast Guard Outpatient Clinic/Center (261QM1100X), and the practice location is in El Paso, TX. The record was last updated on Jan 7, 2013.