Provider Demographics
NPI:1215960919
Name:ALAMO PSYCHIATRIC CARE P. A.
Entity type:Organization
Organization Name:ALAMO PSYCHIATRIC CARE P. A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMASO
Authorized Official - Middle Name:ANDRES
Authorized Official - Last Name:OLIVA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:210-225-3764
Mailing Address - Street 1:343 W HOUSTON ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-2107
Mailing Address - Country:US
Mailing Address - Phone:210-225-3764
Mailing Address - Fax:210-226-7153
Practice Address - Street 1:343 W HOUSTON ST
Practice Address - Street 2:STE 301
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-2385
Practice Address - Country:US
Practice Address - Phone:210-225-3764
Practice Address - Fax:210-226-7153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0968174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176425002Medicaid
TX176425002Medicaid