Provider Demographics
NPI:1770994105
Name:ALON FAMILY HEALTH PLLC
Entity type:Organization
Organization Name:ALON FAMILY HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:210-534-2566
Mailing Address - Street 1:11503 NW MILITARY HWY
Mailing Address - Street 2:SUITE 111
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1884
Mailing Address - Country:US
Mailing Address - Phone:210-534-2566
Mailing Address - Fax:
Practice Address - Street 1:11503 NW MILITARY HWY STE 111
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231-1884
Practice Address - Country:US
Practice Address - Phone:210-534-2566
Practice Address - Fax:210-510-2912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-20
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1012207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty