Provider Demographics
NPI:1992174502
Name:ALAMO CITY FIRST ASSIST, LLC
Entity type:Organization
Organization Name:ALAMO CITY FIRST ASSIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAURICIO
Authorized Official - Middle Name:
Authorized Official - Last Name:CENTENO
Authorized Official - Suffix:
Authorized Official - Credentials:LSA
Authorized Official - Phone:210-606-8213
Mailing Address - Street 1:19026 STONE OAK PKWY STE 210B
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3229
Mailing Address - Country:US
Mailing Address - Phone:210-606-8213
Mailing Address - Fax:
Practice Address - Street 1:19026 STONE OAK PKWY STE 210B
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3229
Practice Address - Country:US
Practice Address - Phone:210-606-8213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-24
Last Update Date:2020-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty