Provider Demographics
NPI:1942965702
Name:AHRMENDI, ALEX B SR
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:B
Last Name:AHRMENDI
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5707 TPC PKWY APT 814
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78261-2786
Mailing Address - Country:US
Mailing Address - Phone:210-797-1039
Mailing Address - Fax:
Practice Address - Street 1:5707 TPC PKWY APT 814
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78261-2786
Practice Address - Country:US
Practice Address - Phone:210-797-1039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-05
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
M225700000X
TXMT135840225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist