Provider Demographics
NPI:1588816110
Name:ALAMO CHIROPRACTIC & REHAB CENTER PLLC
Entity Type:Organization
Organization Name:ALAMO CHIROPRACTIC & REHAB CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE OFFICER, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:
Authorized Official - Last Name:VATANKHA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:210-979-6777
Mailing Address - Street 1:12042 BLANCO RD STE 302
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-5438
Mailing Address - Country:US
Mailing Address - Phone:210-979-6777
Mailing Address - Fax:210-979-6778
Practice Address - Street 1:12042 BLANCO RD STE 302
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-5438
Practice Address - Country:US
Practice Address - Phone:210-979-6777
Practice Address - Fax:210-979-6778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty