Organization
ALFONSO H LUEVANO MD P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALFONSO H LUEVANO M.D. (MEDICAL DIRECTOR)
(830) 876-9458
Entity
Organization
Contact information
Practice address
504 HOSPITAL DR STE B, CARRIZO SPRINGS, TX 78834-3835
(830) 876-9458
(830) 876-2411
Mailing address
PO BOX 278, CARRIZO SPRINGS, TX 78834-6278
(830) 876-9458
(830) 876-2411
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
L7622
TX
208D00000X
General Practice Physician
Primary
L7622
TX
261QM1300X
Multi-Specialty Clinic/Center
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
344750001
—
TX
Enumeration date
01/31/2009
Last updated
09/27/2018
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