Provider Demographics
NPI:1962959304
Name:ALAMO RANCH INTEGRATIVE MEDICINE
Entity type:Organization
Organization Name:ALAMO RANCH INTEGRATIVE MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TEOFILO
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-473-7920
Mailing Address - Street 1:11345 ALAMO RANCH PKWY
Mailing Address - Street 2:103
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-6440
Mailing Address - Country:US
Mailing Address - Phone:210-473-7920
Mailing Address - Fax:
Practice Address - Street 1:11345 ALAMO RANCH PKWY
Practice Address - Street 2:103
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-6442
Practice Address - Country:US
Practice Address - Phone:210-473-7920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72546101YP2500X
TX10979101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1043500333OtherPREVIOUS NPI