59TH MDW-Whasc-Lackland

Primary specialty

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

Legal business name

59TH MDW-WHASC-LACKLAND

Doing business as

DOD REID ePhcy

Practice address

1940 Carswell Ave
BLDG 7002
Lackland, TX 78236

Phone

(210) 671-9637

Fax

(210) 671-6486

NPI assigned

Jun 20, 2018

Last updated

Jun 13, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

59TH MDW-WHASC-LACKLANDAs reported in NPPES

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

Authorized official

Name

Cynthia De la Cruz

Title

MTF Support

Phone

(210) 536-6650

Specialties & licenses 1

Addresses

Other names 1

• DOD REID ePhcy Doing business as

Tax ID family

Willford Hall Medical Ctr4 organizations share this tax ID, including this one

Part of

Willford Hall Medical Ctr

Other organizations with this tax ID 3

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

• 59TH MDW-Whasc-Lackland

  dba DoD LACKLAND ePhcy

  • Military/U.S. Coast Guard Pharmacy
  • Lackland AFB, TX
  • NPI 1063829414
  NPD tax ID
• 59TH MDW-Whasc-Lackland

  dba DoD BULVERDE ePHCY

  • Military/U.S. Coast Guard Pharmacy
  • San Antonio, TX
  • NPI 1184122749
  NPD tax ID
• 59TH MDW-Whasc-Lackland

  dba DoD RANDOLPH BX ePhcy

  • Military/U.S. Coast Guard Pharmacy
  • Randolph AFB, TX
  • NPI 1861800567
  NPD tax ID

Locations

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749772800000",
    "number": "1699269852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 CARSWELL AVE",
            "address_2": "BLDG 7002",
            "city": "LACKLAND",
            "state": "TX",
            "postal_code": "78236",
            "telephone_number": "210-671-9637",
            "fax_number": "210-671-6486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 CARSWELL AVE",
            "address_2": "BLDG 7002",
            "city": "LACKLAND",
            "state": "TX",
            "postal_code": "78236",
            "telephone_number": "210-671-9637",
            "fax_number": "210-671-6486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "59TH MDW-WHASC-LACKLAND",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "59TH MDW-WHASC-LACKLAND",
        "enumeration_date": "2018-06-20",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A",
        "authorized_official_last_name": "DE LA CRUZ",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "MTF SUPPORT",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DOD REID ePhcy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DOD REID ePhcy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sonja L Banks-Gay, RPH
• Jeffrey Daniel Bateman, PA-C
• Susan E Dellaripa, D.M.D.
• Daniel Rossman, R.PH.

• Military/U.S. Coast Guard Pharmacy in Lackland, TX
• Providers in Lackland, 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 Jun 13, 2025; 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.