Healthcare Provider Details

I. General information

NPI: 1831415959
Provider Name (Legal Business Name): ALLIED HAND & ORTHOPEDICS, SAN ANTONIO, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2010
Last Update Date: 04/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18518 HARDY OAK BLVD 205
SAN ANTONIO TX
78258-4759
US

IV. Provider business mailing address

PO BOX 925185
HOUSTON TX
77292-5185
US

V. Phone/Fax

Practice location:
  • Phone: 713-586-6705
  • Fax: 713-586-6752
Mailing address:
  • Phone: 713-586-6705
  • Fax: 713-586-6752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number801163357
License Number StateTX

VIII. Authorized Official

Name: MS. LINDA C KELLNER
Title or Position: DIRECTOR OF MEDICAL CREDENTIALING
Credential:
Phone: 713-586-6705