Provider Demographics
NPI:1184981581
Name:ALAMO SURGICAL ASSISTANTS LLC
Entity type:Organization
Organization Name:ALAMO SURGICAL ASSISTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:JESUS
Authorized Official - Last Name:MIER
Authorized Official - Suffix:JR
Authorized Official - Credentials:SA-C
Authorized Official - Phone:210-875-6309
Mailing Address - Street 1:PO BOX 581
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-0581
Mailing Address - Country:US
Mailing Address - Phone:210-875-6309
Mailing Address - Fax:210-547-2831
Practice Address - Street 1:19051 BANDERA RD
Practice Address - Street 2:
Practice Address - City:HELOTES
Practice Address - State:TX
Practice Address - Zip Code:78023-2803
Practice Address - Country:US
Practice Address - Phone:210-875-6309
Practice Address - Fax:210-547-2831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-23
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty