OrganizationActive
12th Medical Group Randolph
NPI 1316911597 · Military/U.S. Coast Guard Outpatient Clinic/Center · Randolph a F B, TX
Provider details
- NPI number
- 1316911597
- Entity type
- Organization
- Primary specialty
- Military/U.S. Coast Guard Outpatient Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Serena Hansken, Air Force Uniform Business Office
Practice location
221 3rd St W
Bldg 1040
Randolph a F B, TX 78150-4800
Phone: (210) 652-2420
Fax: (210) 652-6571
Mailing address
221 3rd St W
Randolph a F B, TX 78150-4800
Registry dates
- Enumerated
- 2006-02-15
- Last updated
- 2010-11-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.