12th Medical Group Randolph
NPI #1316911597 in Randolph a F B, Texas
Provider Information
- NPI Number
- 1316911597
- Entity Type
- Organization
- Organization Name
- 12th Medical Group Randolph
- Primary Specialty
- Clinic/Center - Military/U.S. Coast Guard Outpatient
- Enumeration Date
- Feb 15, 2006
- Last Updated
- Nov 15, 2010
Practice Location
- Address
- 221 3RD ST W
- Address 2
- BLDG 1040
- City
- Randolph a F B
- State
- Texas
- ZIP Code
- 78150-4800
- Phone
- (210) 652-2420
Authorized Official
- Name
- SERENA LYNN HANSKEN
- Title
- AIR FORCE UNIFORM BUSINESS OFFICE
- Phone
- (703) 588-6419
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Military and U.S. Coast Guard Ambulatory Procedure — Military and U.S. Coast Guard Ambulatory Procedure |
| Military/U.S. Coast Guard Pharmacy |
| Clinic/Center - Military/U.S. Coast Guard Outpatient — Military/U.S. Coast Guard Outpatient |
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