MEDICARE: DR. ALICE ANN EPPERSON M.D.

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	207Q00000X	Family Medicine Physician	K2899	TX

General Provider Information

NPI Number	:	1407821481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALICE ANN EPPERSON M.D.

Provider Business Mailing Address
First Line	:	6243 IH 10 W
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78201-2089
Country	:	US
Telephone Number	:	210-731-4800
Fax Number	:	210-731-4810

Provider Business Practice Location Address
First Line	:	7254 BLANCO RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-4930
Country	:	US
Telephone Number	:	210-384-8282
Fax Number	:	210-384-8629

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	05/30/2012

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