Provider Demographics
NPI:1841208832
Name:ALAMO ENT ASSOCIATES
Entity Type:Organization
Organization Name:ALAMO ENT ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:W
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-616-0096
Mailing Address - Street 1:PO BOX 2679
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78299-2679
Mailing Address - Country:US
Mailing Address - Phone:210-616-0096
Mailing Address - Fax:210-614-1003
Practice Address - Street 1:7840 FLOYD CUEL
Practice Address - Street 2:SUITE 400
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-616-0096
Practice Address - Fax:210-614-1003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0829701Medicaid
00H94NMedicare ID - Type Unspecified