Provider Demographics
NPI:1922195510
Name:BROOKE ARMY MEDICAL CENTER
Entity Type:Organization
Organization Name:BROOKE ARMY MEDICAL CENTER
Other - Org Name:AMC BAMC-FSH
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF, UNIFORM BUSINESS OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:NORA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALPIZAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-916-8563
Mailing Address - Street 1:3551 ROGER BROOKE DR
Mailing Address - Street 2:MCHE-COU-M DEPT 211
Mailing Address - City:FT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4501
Mailing Address - Country:US
Mailing Address - Phone:210-916-8563
Mailing Address - Fax:
Practice Address - Street 1:3851 ROGER BROOKE DR
Practice Address - Street 2:
Practice Address - City:JBSA FT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4501
Practice Address - Country:US
Practice Address - Phone:210-916-4141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM1100X, 261QM1101X, 286500000X, 2865M2000X
TX286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital
No261QM1100XAmbulatory Health Care FacilitiesClinic/CenterMilitary/U.S. Coast Guard Outpatient
No261QM1101XAmbulatory Health Care FacilitiesClinic/CenterMilitary and U.S. Coast Guard Ambulatory Procedure
No2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX021756401Medicaid
TX36JKOtherBC BS PROVIDER NUMBER
TXHH6037OtherBC BS PROVIDER NUMBER
4503884OtherNCPDP
AN2598588OtherMEDCO
TXHH6037OtherBC BS PROVIDER NUMBER
OTH000Medicare UPIN
VAD000Medicare UPIN