Usaf | |
2200 Berquist Drive, Suite 1 Attn: Credentials Jbsa-lackland TX 78236-9908 | |
(210) 292-6707 | |
Not Available |
Full Name | Usaf |
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Speciality | Clinic/center - Adult Mental Health |
Location | 2200 Berquist Drive, Suite 1, Jbsa-lackland, Texas |
Authorized Official Name and Position | Darlon Jackson (CREDENTIALS MANAGER) |
Authorized Official Contact | 2102926707 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Usaf 2200 Berquist Drive, Suite 1 Attn: Credentials Jbsa-lackland TX 78236-9908 Ph: () - | Usaf 2200 Berquist Drive, Suite 1 Attn: Credentials Jbsa-lackland TX 78236-9908 Ph: (210) 292-6707 |
NPI Number | 1386187656 |
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Provider Enumeration Date | 11/18/2016 |
Last Update Date | 11/18/2016 |
Identifier | Type | State | Issuer |
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1386187656 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |