| Usaf | |
|
2200 Berquist Drive, Suite 1 Attn: Credentials Jbsa-lackland TX 78236-9908 | |
| (210) 292-6707 | |
| Not Available |
| Full Name | Usaf |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 11/18/2016 |
| Last Update Date | 11/18/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386187656 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |