Provider Demographics
NPI:1093752909
Name:HIBBERD, ALAN E (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:E
Last Name:HIBBERD
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 1:23704 UP MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78255-2002
Mailing Address - Country:US
Mailing Address - Phone:210-355-6190
Mailing Address - Fax:
Practice Address - Street 1:138 OLD SAN ANTONIO RD STE 302
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-3491
Practice Address - Country:US
Practice Address - Phone:210-705-5060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE0979207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX151016602Medicaid
TXP00060374OtherRAILROAD MEDICARE
TX2879632OtherCIGNA
TX4576828OtherAETNA
TX8K6272OtherBCBS
TX4576828OtherAETNA
TXG49217Medicare UPIN