Alamo Heights Dermatology PA
Organization Active NPI Dermatology Physician · San Antonio, TX
NPI 1285961847 · NPPES record last updated Jul 26, 2024
Key facts
- NPI
- 1285961847
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dermatology Physician 207N00000X
- Legal business name
- ALAMO HEIGHTS DERMATOLOGY PA
- Practice address
- 131 W Sunset Rd Ste 101
San Antonio, TX 78209-2797 - Phone
- (210) 255-8447
- Fax
- (210) 255-8446
- NPI assigned
- Nov 3, 2009
- Organization subpart
- No
Authorized official
- Name
- Mrs. Brenda Carrasco
- Title
- Office Manager
- Phone
- (210) 255-8447
Practitioners 7
-
Rebecca Lewis Kelso, M.D.
-
Kimberley Michelle Totman, PA - PHYSICIAN ASSIS
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100315000155 | TX | Part B Supplier - Clinic/Group Practice | 6608901871 |
Receives reassigned benefits from 7 practitioners Practice locations: San Antonio, TX |
National Provider Directory
Locations
121 Bulverde Crossing Rd
Ste 110
Bulverde, TX 78163
Phone (830) 380-3031
414 W Sunset Rd
Ste 210
San Antonio, TX 78209
Phone (210) 255-8447
131 W Sunset Rd
Ste 101
San Antonio, TX 78209
Phone (210) 225-8447
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BDBIAA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | Yes |
Addresses
Primary practice location
131 W Sunset Rd Ste 101
San Antonio, TX 78209-2797
Mailing address
131 W Sunset Rd Ste 101
San Antonio, TX 78209-2797
Phone (210) 255-8447
Other practice location 1
121 Bulverde Crossing Rd Ste 110
Bulverde, TX 78163-6201
Phone (830) 380-3031
Other providers in San Antonio, TX
- Alamo Heights Complete Care LLC
- Alamo Heights Concierge Psychiatry PLLC
- Alamo Heights Counseling Inc.
- Alamo Heights Dental, PLLC
- Alamo Heights Dentistry for Children, PLLC
- Alamo Heights Ers Acquisition Partners LLC
- Alamo Heights Independent School District
- Alamo Heights Internal Medicine, PA
- Alamo Heights Medical Associates, PA
- Alamo Heights Medical Clinic PLLC
All providers in San Antonio, TX · Dermatology Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.