Provider Demographics
NPI:1780827758
Name:ALAMO URGENT CARE PLLC
Entity Type:Organization
Organization Name:ALAMO URGENT CARE PLLC
Other - Org Name:COMPLETE URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:DEYKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-520-3737
Mailing Address - Street 1:10628 CULEBRA RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-1320
Mailing Address - Country:US
Mailing Address - Phone:210-520-3737
Mailing Address - Fax:
Practice Address - Street 1:10628 CULEBRA RD STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-1320
Practice Address - Country:US
Practice Address - Phone:210-520-3737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-07
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0A4521Medicare PIN
TX6648060001Medicare NSC