Healthcare Provider Details

I. General information

NPI: 1568589851
Provider Name (Legal Business Name): ALAMO CHILDREN'S ADVOCACY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7130 W US HIGHWAY 90
SAN ANTONIO TX
78227-3515
US

IV. Provider business mailing address

7130 W US HIGHWAY 90
SAN ANTONIO TX
78227-3515
US

V. Phone/Fax

Practice location:
  • Phone: 210-675-9000
  • Fax: 210-675-9020
Mailing address:
  • Phone: 210-675-9000
  • Fax: 210-675-9020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateTX

VIII. Authorized Official

Name: MR. MARK A. CARMONA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 210-675-9000