MEDICARE: ALAMO AREA MOBILE PODIATRY SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1184659492
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALAMO AREA MOBILE PODIATRY SERVICES

Provider Business Mailing Address
First Line	:	8500 VILLAGE DR
Second Line	:	SUITE 201
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-5515
Country	:	US
Telephone Number	:	210-656-7000
Fax Number	:	210-656-7002

Provider Business Practice Location Address
First Line	:	8500 VILLAGE DR
Second Line	:	SUITE 201
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-5515
Country	:	US
Telephone Number	:	210-656-7000
Fax Number	:	210-656-7002

Authorized Official
Title or Position	:	OWNER
Name	:	LARRY J COHEN
Credential	:	DPM
Telephone Number	:	210-656-7000

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	06/07/2012

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