Provider Demographics
NPI:1386821031
Name:ALAMO, JOSE IGNACIO JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:IGNACIO
Last Name:ALAMO
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 ELMHURST
Mailing Address - Street 2:STE A
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-6396
Mailing Address - Country:US
Mailing Address - Phone:512-722-6131
Mailing Address - Fax:
Practice Address - Street 1:165 ELMHURST
Practice Address - Street 2:STE A
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6396
Practice Address - Country:US
Practice Address - Phone:512-722-6131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0537381223G0001X
TX24068122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice