MEDICARE: ALEMU MEDICAL HOME, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1205352366
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALEMU MEDICAL HOME, PLLC

Provider Business Mailing Address
First Line	:	790 GENERATIONS DR STE 205
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-0087
Country	:	US
Telephone Number	:	830-351-5066
Fax Number	:	830-351-5460

Provider Business Practice Location Address
First Line	:	790 GENERATIONS DR STE 205
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-0087
Country	:	US
Telephone Number	:	830-351-5066
Fax Number	:	830-351-5460

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BENYAM ALEMU
Credential	:	MD
Telephone Number	:	830-351-5066

Provider Enumeration Date	:	08/20/2017
Last Update Date	:	03/18/2024

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