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Organization
LINDA I ALFONSO MD PA
Active
Organization
LINDA I ALFONSO MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY DEHAVEN (CREDENTIALING SPECIALIST)
(210) 615-9990
Entity
Organization
Contact information
Practice address
10515 SH 151 STE 240, SAN ANTONIO, TX 78251-4409
(210) 393-3812
Mailing address
PO BOX 2205, SAN ANTONIO, TX 78298-2205
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M5020
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M5020
LISCENSE
TX
Enumeration date
04/11/2008
Last updated
04/11/2008
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