Organization Name: | ALAMO CITY MEDICAL GROUP PA |
NPI Number: | 1205274495 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT HASSETT (PRESIDENT) |
Mailing Address: | 518 N Main St Boerne |
State: | TX US |
Postal Code: | 780061620 |
Phone Number: | 8302495400 |
Fax Number: | |
NPI Enumeration Date: | 06/10/2013 |
NPI Last Update Date: | 06/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |