RANDOLPH AFB CLINIC
NPI 1316911597
Clinic/Center - Military/U.S. Coast Guard Outpatient in Randolph A F B, TX

Active since February 15, 2006
221 3RD ST W, BLDG 1040, RANDOLPH A F B, TX 78150(210) 652-2420(210) 652-6571 Get Directions Write a Review

NPPES record last updated: November 15, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Randolph Afb Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RANDOLPH AFB CLINIC (NPI 1316911597) is a healthcare organization registered as a military/u.s. coast guard outpatient in Randolph A F B, Texas and active in the NPI registry since February 2006. The organization lists Serena Lynn Hansken, Air Force Uniform Business Office, as its authorized official.

NPPES Registry Identity

NPI1316911597
Entity TypeOrganization
Primary Taxonomy261QM1100X
Legal Business Name12TH MEDICAL GROUP RANDOLPH
Location Address221 3RD ST W, BLDG 1040Randolph A F B, TX 78150-4800
Mailing Address221 3rd St W, Bldg 1040Randolph A F B, TX 78150-4800 · (210) 652-2420 · Fax (210) 652-6571
Fax(210) 652-6571
Organization SubpartNo
Authorized OfficialSerena Lynn HanskenAir Force Uniform Business Office · (703) 588-6419
Enumeration DateFebruary 15, 2006
Last NPPES UpdateNovember 15, 2010
NPI 1316911597 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyClinic/Center · Military/U.S. Coast Guard OutpatientAmbulatory Health Care Facilities
Taxonomy Code261QM1100X
Definition
The Defense Health Program or U.S. Coast Guard funded fixed facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A fixed facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the fixed facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport.
Also ListedMilitary/U.S. Coast Guard PharmacyTaxonomy 332000000X
221 3RD ST W, Randolph A F B, TX 78150

Other Names 1

Other NameRandolph Afb Clinic

Other Identifiers 1

Other4512908TX · Ncpdp

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pediatrics
221 3RD ST W
RANDOLPH A F B, TX 78150
Nurse Practitioner (Pediatrics)
221 3RD ST W
RANDOLPH AFB, TX 78150
Dentist (General Practice)
221 3RD ST W
RANDOLPH A F B, TX 78150
Pharmacist
221 3RD ST W
RANDOLPH AFB, TX 78150
Social Worker
221 3RD ST W
JBSA RANDOLPH, TX 78150
Social Worker (Clinical)
221 3RD ST W
RANDOLPH AFB, TX 78150
Nurse Practitioner (Acute Care)
221 3RD ST W
RANDOLPH AFB, TX 78150
Physician Assistant
221 3RD ST W
RANDOLPH AFB, TX 78150

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 12th Medical Group Randolph's NPI number?

The NPI number for 12th Medical Group Randolph is 1316911597. It was assigned to this organization in the NPPES registry on February 15, 2006. The provider is also known as Randolph Afb Clinic.

Where is 12th Medical Group Randolph located?

12th Medical Group Randolph is located at 221 3rd St W Bldg 1040, Randolph A F B, TX 78150. The listed phone number is (210) 652-2420.

What is 12th Medical Group Randolph's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Military/U.S. Coast Guard Outpatient, with taxonomy code 261QM1100X.

When was this NPI record last updated?

The NPPES record for 12th Medical Group Randolph was last updated on November 15, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.