Provider Demographics
NPI:1063859189
Name:ALAMO, JORGE G (MD)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:G
Last Name:ALAMO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2129
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79760-2129
Mailing Address - Country:US
Mailing Address - Phone:432-640-6476
Mailing Address - Fax:432-640-4758
Practice Address - Street 1:8050 E HIGHWAY 191
Practice Address - Street 2:SUITE 104
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79765-8613
Practice Address - Country:US
Practice Address - Phone:432-640-6476
Practice Address - Fax:432-640-4758
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ91062083X0100X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine