Provider Demographics
NPI:1285961847
Name:ALAMO HEIGHTS DERMATOLOGY PA
Entity type:Organization
Organization Name:ALAMO HEIGHTS DERMATOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRASCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-255-8447
Mailing Address - Street 1:131 W SUNSET RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-2797
Mailing Address - Country:US
Mailing Address - Phone:210-255-8447
Mailing Address - Fax:210-255-8446
Practice Address - Street 1:131 W SUNSET RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-2797
Practice Address - Country:US
Practice Address - Phone:210-255-8447
Practice Address - Fax:210-255-8446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-03
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty