Provider Demographics
NPI:1689121006
Name:CARL DARNALL ARMY MEDICAL CENTER
Entity Type:Organization
Organization Name:CARL DARNALL ARMY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE STAFF PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DORIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:936-443-4804
Mailing Address - Street 1:CARL DARNALL ARMY MEDICAL CENTER
Mailing Address - Street 2:36065 SANTE FE AVE FORT HOOD, TEXAS
Mailing Address - City:APO
Mailing Address - State:AA
Mailing Address - Zip Code:76544-9997
Mailing Address - Country:US
Mailing Address - Phone:254-553-5319
Mailing Address - Fax:
Practice Address - Street 1:CARL DARNALL ARMY MEDICAL CENTER
Practice Address - Street 2:36065 SANTE FE AVE
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:76544-9997
Practice Address - Country:US
Practice Address - Phone:254-553-5319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102204108286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital