Provider Demographics
NPI:1619287737
Name:CARL R DARNALL ARMY MEDICAL CENTER
Entity Type:Organization
Organization Name:CARL R DARNALL ARMY MEDICAL CENTER
Other - Org Name:INTENSIVE OUTPNT DAY TMNT CLNC-HOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:UBO MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-288-8693
Mailing Address - Street 1:36000 DARNALL LOOP
Mailing Address - Street 2:ATTN MCXI-RMD-TP
Mailing Address - City:FORT HOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76544-5095
Mailing Address - Country:US
Mailing Address - Phone:254-288-8381
Mailing Address - Fax:
Practice Address - Street 1:BUILDING 36053 WRATTEN DRIVE
Practice Address - Street 2:
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544-5095
Practice Address - Country:US
Practice Address - Phone:254-288-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARL R DARNALL ARMY MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-08
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1100XAmbulatory Health Care FacilitiesClinic/CenterMilitary/U.S. Coast Guard Outpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
1801988779OtherPARENT FACILITY NPI 2
1801988779OtherPARENT FACILITY NPI 2
VAD000Medicare UPIN