Healthcare Provider Details

I. General information

NPI: 1245244185
Provider Name (Legal Business Name): HERNAN JOSE ALAMILLA DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 N MAIN ST
KELLER TX
76248-4433
US

IV. Provider business mailing address

226 N MAIN ST
KELLER TX
76248-4433
US

V. Phone/Fax

Practice location:
  • Phone: 817-337-2576
  • Fax: 817-562-4606
Mailing address:
  • Phone: 817-337-2576
  • Fax: 817-562-4606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number1860
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: