Provider Demographics
NPI:1558747931
Name:UNITED STATES ARMY
Entity Type:Organization
Organization Name:UNITED STATES ARMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIORAL HEALTH PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNPAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:NORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:417-861-7296
Mailing Address - Street 1:14689 AVA LEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-2901
Mailing Address - Country:US
Mailing Address - Phone:915-742-9326
Mailing Address - Fax:
Practice Address - Street 1:5005 N PIEDRAS ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79920-5002
Practice Address - Country:US
Practice Address - Phone:915-742-9326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0097732865M2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital