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General NPI Number Information
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NPI Number | 1407621675
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Entity Type | Organization
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Legal Business Name | ALAMO HEIGHTS ORAL SURGERY, PLLC
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Dates
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Enumeration Date | 11/17/2023
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Last Update Date | 11/17/2023
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Provider Practice Location Address
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Address Line | 6710 N NEW BRAUNFELS AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78209-3830
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Country | US
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Telephone | 210-828-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 4242 BROADWAY APT 401
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City | SAN ANTONIO
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State | TX
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Zip | 78209-6452
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Country | US
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Telephone | 210-632-5507
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTMER
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Name | DR. BRENDAN TIMOTHY FARRELL
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Credential | DDS
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Telephone | 210-632-5507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number |
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License Number State |
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