Provider Demographics
NPI:1114462702
Name:ALAMO WOMEN'S OBSTETRICS & GYNECOLOGY, PLLC
Entity Type:Organization
Organization Name:ALAMO WOMEN'S OBSTETRICS & GYNECOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-281-5066
Mailing Address - Street 1:11212 STATE HIGHWAY 151 SUITE 350
Mailing Address - Street 2:PLAZA 2
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251
Mailing Address - Country:US
Mailing Address - Phone:210-281-5066
Mailing Address - Fax:210-281-4459
Practice Address - Street 1:11212 STATE HIGHWAY 151 SUITE 350
Practice Address - Street 2:PLAZA 2
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251
Practice Address - Country:US
Practice Address - Phone:210-281-5066
Practice Address - Fax:210-281-4459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-05
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6336207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX381292701Medicaid