Healthcare Provider Details

I. General information

NPI: 1215805304
Provider Name (Legal Business Name): ALEXIS LINDSAY ALTAMIRANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2025
Last Update Date: 10/29/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BLUFF CREEK TOWER, 4201 MEDICAL DRIVE SUITE 260
SAN ANTONIO TX
78229
US

IV. Provider business mailing address

BLUFF CREEK TOWER, 4201 MEDICAL DRIVE SUITE 260
SAN ANTONIO TX
78229
US

V. Phone/Fax

Practice location:
  • Phone: 210-949-9010
  • Fax:
Mailing address:
  • Phone: 210-949-9010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: