Provider Demographics
NPI:1467794438
Name:ALAMO FAMILY FOOT CARE, PA
Entity Type:Organization
Organization Name:ALAMO FAMILY FOOT CARE, PA
Other - Org Name:ALAMO FAMILY FOOT & ANKLE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:210-829-8770
Mailing Address - Street 1:9502 HUEBNER RD
Mailing Address - Street 2:BUILDING 2, SUITE 201
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1649
Mailing Address - Country:US
Mailing Address - Phone:210-829-8770
Mailing Address - Fax:210-446-5789
Practice Address - Street 1:9502 HUEBNER RD
Practice Address - Street 2:BUILDING 2, SUITE 201
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1649
Practice Address - Country:US
Practice Address - Phone:210-829-8770
Practice Address - Fax:210-446-5789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-18
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1350213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092748502Medicaid
1093150003Medicare NSC
84W402Medicare PIN
U65066Medicare UPIN