NPIMap

Organization Active NPI

Branch Medical Clinic Ft Worth

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Naval Air Station/ JRB, TX
National Provider Identifier
1114986932
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
BRANCH MEDICAL CLINIC FT WORTH
Practice address
1711 Doolittle Ave
Naval Air Station/ JRB, TX 76127
Phone
(361) 961-6079
Fax
(361) 961-2611
NPI assigned
Mar 21, 2006
Organization subpart
Yes
Parent organization
NAVAL HEALTH CLINIC CORPUS CHRISTIAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 25, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
William M Condon
Title
Bumed Ubo
Phone
(240) 401-3643

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military/U.S. Coast Guard Outpatient Clinic/Center 261QM1100X Primary

Addresses

Primary practice location

1711 Doolittle Ave
Naval Air Station/ JRB, TX 76127

Mailing address

1711 Doolittle Ave
Naval Air Station/ JRB, TX 76127-1133
Phone (361) 961-6079

National Provider Directory

National Provider Directory
Tax ID family
Branch Medical Clinic Ft Worth6 organizations share this tax ID, including this one
Part of
Branch Medical Clinic Ft Worth

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527206400000",
    "number": "1114986932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 DOOLITTLE AVE",
            "city": "NAVAL AIR STATION/ JRB",
            "state": "TX",
            "postal_code": "761271133",
            "telephone_number": "361-961-6079",
            "fax_number": "361-961-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 DOOLITTLE AVE",
            "city": "NAVAL AIR STATION/ JRB",
            "state": "TX",
            "postal_code": "76127",
            "telephone_number": "361-961-6079",
            "fax_number": "361-961-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANCH MEDICAL CLINIC FT WORTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NAVAL HEALTH CLINIC CORPUS CHRISTI",
        "enumeration_date": "2006-03-21",
        "last_updated": "2018-05-25",
        "status": "A",
        "authorized_official_last_name": "CONDON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BUMED UBO",
        "authorized_official_telephone_number": "240-401-3643"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naval Air Station/ JRB, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.