Provider Demographics
NPI:1114396991
Name:ALAMO CITY SURGERY CENTER
Entity Type:Organization
Organization Name:ALAMO CITY SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-614-4742
Mailing Address - Street 1:7402 JOHN SMITH
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4588
Mailing Address - Country:US
Mailing Address - Phone:210-614-4742
Mailing Address - Fax:
Practice Address - Street 1:7402 JOHN SMITH
Practice Address - Street 2:SUITE 104
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4588
Practice Address - Country:US
Practice Address - Phone:210-614-4742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX130238261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE3654OtherMEDICAL LICENSE
TXE6484OtherMEDICAL LICENSE
E9513OtherMEDICAL LICENSE
TXG6650OtherMEDICAL LICENSE