Provider Demographics
NPI:1932100427
Name:CITY OF ALAMO HEIGHTS
Entity type:Organization
Organization Name:CITY OF ALAMO HEIGHTS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:OTTMERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-824-1281
Mailing Address - Street 1:6116 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209
Mailing Address - Country:US
Mailing Address - Phone:210-824-1281
Mailing Address - Fax:210-828-3006
Practice Address - Street 1:6116 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-4545
Practice Address - Country:US
Practice Address - Phone:210-824-1281
Practice Address - Fax:210-828-3006
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF ALAMO HEIGHTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-08-09
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0150273416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0002214-01Medicaid
TX508431Medicare ID - Type UnspecifiedPROVIDER NUMBER