Healthcare Provider Details

I. General information

NPI: 1336561331
Provider Name (Legal Business Name): ALCOCER PRIMARY HOME CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2014
Last Update Date: 09/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 FREDERICKSBURG RD SUITE 203
SAN ANTONIO TX
78201-3269
US

IV. Provider business mailing address

3700 FREDERICKSBURG RD SUITE 203
SAN ANTONIO TX
78201-3269
US

V. Phone/Fax

Practice location:
  • Phone: 210-785-9311
  • Fax: 210-785-9989
Mailing address:
  • Phone: 210-785-9311
  • Fax: 210-785-9311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number016169
License Number StateTX

VIII. Authorized Official

Name: BRUNO ALEXANDER ALCOCER
Title or Position: DIRECTOR
Credential:
Phone: 210-785-9311