Provider Demographics
NPI:1194823617
Name:ALAMO HEART ASSOCIATES PA
Entity Type:Organization
Organization Name:ALAMO HEART ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-616-3313
Mailing Address - Street 1:2833 BABCOCK RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4894
Mailing Address - Country:US
Mailing Address - Phone:210-614-6391
Mailing Address - Fax:210-616-0052
Practice Address - Street 1:2833 BABCOCK RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4894
Practice Address - Country:US
Practice Address - Phone:210-614-6391
Practice Address - Fax:210-616-0052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CP0022OtherMEDICARE RAILROAD
TX00F22EOtherGROUP BCBS #
TX082431001Medicaid
TX00F22EMedicare ID - Type UnspecifiedGROUP MEDICARE NUMBER