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1578928099 NPI number — ALAMO DIVERSE MEDICAL SERVICES PLLC

NPI Number: 1578928099
Health Care Provider/Practitioner: ALAMO DIVERSE MEDICAL SERVICES PLLC

Information about “1578928099” NPI (ALAMO DIVERSE MEDICAL SERVICES PLLC) exists in 1578928099 in HTML format HTML  |  1578928099 in plain Text format TXT  |  1578928099 in PDF (Portable Document Format) PDF  |  1578928099 in an XML format XML  formats.

NPI Number : 1578928099 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1578928099",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ALAMO DIVERSE MEDICAL SERVICES PLLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "8508 SIR LANCELOT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAN ANTONIO",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78240-4920",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "210-346-8188",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "8508 SIR LANCELOT",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAN ANTONIO",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78240-4920",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "210-346-8188",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/29/2015",
    "LastUpdateDate": "01/23/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ALTAMIRANO",
    "AuthorizedOfficialFirstName": "RAY",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PHYSICIAN/MANAGER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "210-912-1969",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207Q00000X",
        "TaxonomyName": "Family Medicine Physician",
        "LicenseNumber": "P0535",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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