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General NPI Number Information
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NPI Number | 1205274495
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Entity Type | Organization
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Legal Business Name | ALAMO CITY MEDICAL GROUP PA
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Dates
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Enumeration Date | 06/10/2013
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Last Update Date | 06/17/2015
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Provider Practice Location Address
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Address Line | 518 N MAIN ST
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City | BOERNE
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State | TX
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Zip | 78006-1620
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Country | US
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Telephone | 830-249-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 5080 SPECTRUM DR SUITE 1200 WEST TOWER
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City | ADDISON
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State | TX
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Zip | 75001-4648
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT HASSETT
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Credential | DO
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Telephone | 972-364-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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