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General NPI Number Information
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NPI Number | 1366771123
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Entity Type | Organization
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Legal Business Name | ALAMO ONCOLOGY ASSOCIATES, PA
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Dates
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Enumeration Date | 12/08/2009
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Last Update Date | 12/08/2009
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Provider Practice Location Address
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Address Line | 8038 WURZBACH RD STE 420
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3817
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Country | US
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Telephone | 210-616-9696
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Fax | 210-695-6245
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Provider Business Mailing Address
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Address Line | 8038 WURZBACH RD STE 420
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3817
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Country | US
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Telephone | 210-616-9696
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Fax | 210-695-6245
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JORY D LANGE
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Credential | M.D.
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Telephone | 210-616-9696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | TX
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