=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376905182
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALAMO INSTITUTE OF PLASTIC SURGERY, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/22/2016
-----------------------------------------------------
Last Update Date | 05/29/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19016 STONE OAK PKWY STE 240
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78258-3281
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-827-3741
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19016 STONE OAK PKWY STE 240
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78258-3281
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-827-3741
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | WILLIAM B ALBRIGHT
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 319-270-5207
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208200000X
-----------------------------------------------------
Taxonomy Name | Plastic Surgery Physician
-----------------------------------------------------
License Number | Q7003
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------