Provider Demographics
NPI:1487247284
Name:ALAMO HEIGHTS MEDICAL CLINIC PLLC
Entity type:Organization
Organization Name:ALAMO HEIGHTS MEDICAL CLINIC PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FNU
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJLAKSHMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-262-6413
Mailing Address - Street 1:128 AUBURN PL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-4722
Mailing Address - Country:US
Mailing Address - Phone:210-262-6413
Mailing Address - Fax:
Practice Address - Street 1:1419 AUSTIN HWY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-4337
Practice Address - Country:US
Practice Address - Phone:210-262-6413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-12
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty