NPIMap

Organization Active NPI

Usaf

  • Military Hospital
  • Lackland Afb, TX
National Provider Identifier
1861470957
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military HospitalTaxonomy code 286500000X
License
5934-015 Issued in WI
Legal business name
USAF
Practice address
2200 Berquist Drive
Suite 1
Lackland Afb, TX 78236-5300
Phone
(210) 292-6393
Fax
(210) 292-3338
NPI assigned
Jan 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Randall Judson McDaniel, DMD
Title
Director of Orofacial Pain
Phone
(210) 292-6393

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military Hospital 286500000X 5934-015 WI Primary

Addresses

Primary practice location

2200 Berquist Drive
Suite 1
Lackland Afb, TX 78236-5300

Mailing address

2200 Berquist Drive
Suite 1
Lackland Afb, TX 78236-5300
Phone (210) 292-6393

Other names 1

  • Wilford Hall Medical Center Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861470957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 BERQUIST DRIVE",
            "address_2": "SUITE 1",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782365300",
            "telephone_number": "210-292-6393",
            "fax_number": "210-292-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERQUIST DRIVE",
            "address_2": "SUITE 1",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782365300",
            "telephone_number": "210-292-6393",
            "fax_number": "210-292-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USAF",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "JUDSON",
        "authorized_official_title_or_position": "DIRECTOR OF OROFACIAL PAIN",
        "authorized_official_telephone_number": "210-292-6393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "286500000X",
            "taxonomy_group": "",
            "desc": "Military Hospital",
            "state": "WI",
            "license": "5934-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilford Hall Medical Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lackland Afb, TX

Sources for this page

  • 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.