Provider Demographics
NPI:1366575706
Name:ALAMO AREA FAMILY & GERIATRIC MEDICINE ASSOCIATES, PA
Entity type:Organization
Organization Name:ALAMO AREA FAMILY & GERIATRIC MEDICINE ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:ZEITLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-379-0953
Mailing Address - Street 1:8926 WILLMON WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78239
Mailing Address - Country:US
Mailing Address - Phone:210-340-3455
Mailing Address - Fax:210-340-3457
Practice Address - Street 1:8926 WILLMON WAY
Practice Address - Street 2:
Practice Address - City:WINDCREST
Practice Address - State:TX
Practice Address - Zip Code:78239-1947
Practice Address - Country:US
Practice Address - Phone:210-646-6315
Practice Address - Fax:210-646-6315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7262207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00580UMedicare ID - Type Unspecified