Provider Demographics
NPI:1710396031
Name:7TH MEDICAL GROUP
Entity Type:Organization
Organization Name:7TH MEDICAL GROUP
Other - Org Name:DOD DYESS EPHCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF DHA PASS
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-536-6650
Mailing Address - Street 1:7TH MEDICAL GROUP SGSR
Mailing Address - Street 2:697 LOUISIANA DR.
Mailing Address - City:DYESS AFB
Mailing Address - State:TX
Mailing Address - Zip Code:79607
Mailing Address - Country:US
Mailing Address - Phone:325-696-4677
Mailing Address - Fax:325-696-3359
Practice Address - Street 1:697 LOUISIANA RD
Practice Address - Street 2:
Practice Address - City:DYESS AFB
Practice Address - State:TX
Practice Address - Zip Code:79607-1141
Practice Address - Country:US
Practice Address - Phone:325-696-4677
Practice Address - Fax:325-696-3359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2147206OtherPK