Wilford Hall Medical Center

Primary specialty

Military HospitalTaxonomy code 286500000X

License

40761 Issued in TX

Legal business name

WILFORD HALL MEDICAL CENTER

Practice address

2200 Bergquist Dr
Attn: Credentials (CMC)
Lackland a F B, TX 78236-9907

Phone

(210) 292-6707

Fax

(210) 292-7964

NPI assigned

Feb 21, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Darlene Jackson

Title

Credentials Manager

Phone

(210) 292-6707

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861467193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9911 STONEFIELD PL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782546749",
            "telephone_number": "210-706-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "address_2": "ATTN: CREDENTIALS (CMC)",
            "city": "LACKLAND A F B",
            "state": "TX",
            "postal_code": "782369907",
            "telephone_number": "210-292-6707",
            "fax_number": "210-292-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILFORD HALL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "DARLENE",
        "authorized_official_title_or_position": "CREDENTIALS MANAGER",
        "authorized_official_telephone_number": "210-292-6707",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "286500000X",
            "taxonomy_group": "",
            "desc": "Military Hospital",
            "state": "TX",
            "license": "40761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WHMC PROVIDER NUMBER",
            "identifier": "70319P",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW LICENSE NUMBER",
            "identifier": "40761",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Bruce West, MD MPH
• Shaun Christopher White, PHARM.D.
• Darinda Lee Whitefield, IDMT
• Wilford Hall Medical Center
• Wilford Hall Medical Center
• Wilford Hall Medical Center
• Wilford Hall Usaf Medical Center
• Carl L Williams, M.D.
• Joshua Dale Wilson, PH.D.
• Kondi Wong, M.D.

• Military Hospital in Lackland a F B, TX
• Providers in Lackland a F B, TX by specialty
• Military Hospital in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.