Provider Demographics
NPI:1720208275
Name:ALAMO HEIGHTS MEDICAL ASSOCIATES, PA
Entity Type:Organization
Organization Name:ALAMO HEIGHTS MEDICAL ASSOCIATES, PA
Other - Org Name:DRS CREAMER AND SMITH, MD, PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:H
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:210-824-3130
Mailing Address - Street 1:5307 BROADWAY ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-5743
Mailing Address - Country:US
Mailing Address - Phone:210-824-3130
Mailing Address - Fax:210-828-7123
Practice Address - Street 1:5307 BROADWAY ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-5743
Practice Address - Country:US
Practice Address - Phone:210-824-3130
Practice Address - Fax:210-828-7123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7003174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX082097901Medicaid
TXCD2098OtherMEDICARE RR PTAN
TX00D901Medicare PIN