Provider Demographics
NPI:1649464728
Name:ALPHA PEDIATRICS, PA
Entity type:Organization
Organization Name:ALPHA PEDIATRICS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMAD
Authorized Official - Middle Name:Y
Authorized Official - Last Name:KALDAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-643-7723
Mailing Address - Street 1:502 MADISON OAK
Mailing Address - Street 2:SUITE 245
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4084
Mailing Address - Country:US
Mailing Address - Phone:210-404-2532
Mailing Address - Fax:210-404-2539
Practice Address - Street 1:502 MADISON OAK
Practice Address - Street 2:SUITE 245
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4084
Practice Address - Country:US
Practice Address - Phone:210-404-2532
Practice Address - Fax:210-404-2539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty