359TH MDG

Primary specialty

Military/U.S. Coast Guard PharmacyTaxonomy code 332000000X

Legal business name

359TH MDG

Doing business as

Randolph Phcy

Practice address

221 3Rd St W BLDG 1040
Universal City, TX 78150-4800

Phone

(210) 652-4127

Fax

(210) 652-3516

NPI assigned

Sep 20, 2006

Last updated

Jan 13, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hector Morales

Title

Chief Dha Pass

Phone

(210) 536-6650

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• RANDOLPH PHCY Doing business as

Tax ID family

359TH MDG3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• 12TH Medical Group Randolph

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Randolph AFB, TX
  • NPI 1316911597
  NPD tax ID
• 359TH MDG

  dba Randolph BX Phcy

  • Military/U.S. Coast Guard Pharmacy
  • Randolph AFB, TX
  • NPI 1306160973
  NPD tax ID

Locations

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452643200000",
    "number": "1598862344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 3RD ST W BLDG 1040",
            "city": "UNIVERSAL CITY",
            "state": "TX",
            "postal_code": "781504800",
            "telephone_number": "210-652-4127",
            "fax_number": "210-652-3516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 3RD ST W BLDG 1040",
            "city": "UNIVERSAL CITY",
            "state": "TX",
            "postal_code": "781504800",
            "telephone_number": "210-652-4127",
            "fax_number": "210-652-3516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "359TH MDG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2016-01-13",
        "status": "A",
        "authorized_official_last_name": "MORALES",
        "authorized_official_first_name": "HECTOR",
        "authorized_official_title_or_position": "CHIEF DHA PASS",
        "authorized_official_telephone_number": "210-536-6650"
    },
    "taxonomies": [
        {
            "code": "332000000X",
            "taxonomy_group": "",
            "desc": "Military/U.S. Coast Guard Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2093375",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RANDOLPH PHCY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 2 Orchids Living Solutions, LLC
• A Ideal Transportation (Ideal Trans)
• Matthew Aaker, O.D.
• Abiding Peace Christian Counseling, LLC
• Acacia Counseling
• Nancy A Acerra, LMT, MS RDN LD

• Military/U.S. Coast Guard Pharmacy in Universal City, TX
• Providers in Universal City, TX by specialty
• Military/U.S. Coast Guard Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; 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.