Provider Demographics
NPI:1376045765
Name:ALONZO, AMBER M (PA)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:M
Last Name:ALONZO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 E CARSON ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78208-1616
Mailing Address - Country:US
Mailing Address - Phone:210-273-4657
Mailing Address - Fax:
Practice Address - Street 1:813 CIBOLO VALLEY DR STE 144
Practice Address - Street 2:
Practice Address - City:CIBOLO
Practice Address - State:TX
Practice Address - Zip Code:78108-4558
Practice Address - Country:US
Practice Address - Phone:830-310-6101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-01
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA11833363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant