Juan Alba – Contractor in San Antonio, TX

Key facts

NPI: 1235539008
Entity type: Individual (NPI type 1)
Primary specialty: Contractor 171W00000X
Practice address: 2806 Fredericksburg Rd Ste 104
San Antonio, TX 78201-4705
Phone: (210) 278-2324
Fax: (210) 305-4202
NPI assigned: Aug 29, 2014
Sex: Male
Sole proprietor: Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Med Mobile Life Durable Medical Equipment & Medical Supplies · San Antonio, TX · NPI 1982004396

NPD (past) Authorized official

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Med Mobile Life		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Contractor	171W00000X		TX	Yes

Addresses

Primary practice location

2806 Fredericksburg Rd Ste 104
San Antonio, TX 78201-4705

Mailing address

2806 Fredericksburg Rd Ste 104
San Antonio, TX 78201-4705
Phone (210) 278-2324

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 29, 2014.

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409270400000",
    "number": "1235539008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2806 FREDERICKSBURG RD STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782014705",
            "telephone_number": "210-278-2324",
            "fax_number": "210-305-4202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2806 FREDERICKSBURG RD STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782014705",
            "telephone_number": "210-278-2324",
            "fax_number": "210-305-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALBA",
        "first_name": "JUAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-29",
        "last_updated": "2014-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

All providers in San Antonio, TX · Contractor in Texas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2014. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.