# ALAMO MAXILLOFACIAL SURGICAL ASSOCIATES, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417006065
- **Authorized official:** MRS. KELLY ANN SHY MHSM (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (210) 614-3915

## Contact information

- **Practice address:** 4499 MEDICAL DR, SUITE \#190, SAN ANTONIO, TX 78229-3735
- **Practice address phone:** (210) 614-3915
- **Practice address fax:** (210) 614-3918
- **Mailing address:** 4499 MEDICAL DR, SUITE \#190, SAN ANTONIO, TX 78229-3735
- **Mailing address phone:** (210) 614-3915
- **Mailing address fax:** (210) 614-3918

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 01/10/2007
- **Last updated:** 04/25/2016