Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

12th Medical Group Randolph

Organization Military/U.S. Coast Guard Outpatient Clinic/Center · NPI 1316911597

12th Medical Group Randolph is a Military/U.S. Coast Guard Outpatient Clinic/Center in Randolph A F B, Texas. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
3

Practice location Address checks out

221 3rd St W Bldg 1040
Randolph A F B, TX 78150-4800
Phone: (210) 652-2420
Fax: (210) 652-6571
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Military/U.S. Coast Guard Outpatient Clinic/Center (primary) Taxonomy 261QM1100X
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center Taxonomy 261QM1101X
Military/U.S. Coast Guard Pharmacy Taxonomy 332000000X

Record details

NPI number1316911597
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Serena Hansken — Air Force Uniform Business Office · (703) 588-6419
Other names Randolph Afb Clinic
NPI enumeratedFebruary 15, 2006
Last updated in NPPESNovember 15, 2010
Mailing address221 3rd St W, Bldg 1040, Randolph A F B, TX 78150-4800