| Whasc | |
|
1100 Wilford Hall Loop Bldg 4554 Lackland Afb TX 78236-5638 | |
| (210) 292-6255 | |
| (210) 292-7934 |
| Full Name | Whasc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1100 Wilford Hall Loop Bldg 4554, Lackland Afb, Texas |
| Authorized Official Name and Position | Tila Wan Cole (ADMINISTRATOR) |
| Authorized Official Contact | 2103926483 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Whasc 1100 Wilford Hall Loop Bldg 4554 Lackland Afb TX 78236-5638 Ph: (210) 292-6255 | Whasc 1100 Wilford Hall Loop Bldg 4554 Lackland Afb TX 78236-5638 Ph: (210) 292-6255 |
| NPI Number | 1225846116 |
|---|---|
| Provider Enumeration Date | 12/23/2024 |
| Last Update Date | 12/23/2024 |
| Certification Date | 12/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225846116 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |