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General NPI Number Information
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NPI Number | 1770167181
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Entity Type | Individual
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Provider Name | ALFRED JAVIER LABORDE DO
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Gender | Male
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Dates
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Enumeration Date | 05/11/2021
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 6157 NW LOOP 410 STE 124
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City | SAN ANTONIO
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State | TX
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Zip | 78238-3302
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Country | US
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Telephone | 210-523-1411
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Fax | 210-523-9307
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Provider Business Mailing Address
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Address Line | 6157 NW LOOP 410 STE 124
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City | SAN ANTONIO
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State | TX
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Zip | 78238-3302
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Country | US
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Telephone | 210-523-1411
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Fax | 210-523-9307
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | V2771
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 7843
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License Number State | OK
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