Provider Demographics
NPI:1295737450
Name:ARYA-DEGAETANO, ALKA (DO)
Entity type:Individual
Prefix:DR
First Name:ALKA
Middle Name:
Last Name:ARYA-DEGAETANO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 OAK CENTRE DR
Mailing Address - Street 2:STE 300
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3916
Mailing Address - Country:US
Mailing Address - Phone:210-402-6022
Mailing Address - Fax:210-402-2930
Practice Address - Street 1:525 OAK CENTRE DR
Practice Address - Street 2:STE 300
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3916
Practice Address - Country:US
Practice Address - Phone:210-402-6022
Practice Address - Fax:210-402-2930
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4858207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX158086201Medicaid
TX158086201Medicaid
TX8A0221Medicare Oscar/Certification