# ALFONSO H LUEVANO MD P A

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

## Provider details

- **NPI number:** 1598903353
- **Authorized official:** DR. ALFONSO H LUEVANO M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (830) 876-9458

## Contact information

- **Practice address:** 504 HOSPITAL DR STE B, CARRIZO SPRINGS, TX 78834-3835
- **Practice address phone:** (830) 876-9458
- **Practice address fax:** (830) 876-2411
- **Mailing address:** PO BOX 278, CARRIZO SPRINGS, TX 78834-6278
- **Mailing address phone:** (830) 876-9458
- **Mailing address fax:** (830) 876-2411

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207VX0000X | Obstetrics Physician | L7622 | TX | — |
| 208D00000X | General Practice Physician | L7622 | TX | Yes |
| 261QM1300X | Multi-Specialty Clinic/Center | — | — | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 01/31/2009
- **Last updated:** 09/27/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 344750001 | — | TX |