Alamo Maxillofacial Surgical Associates, PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

ALAMO MAXILLOFACIAL SURGICAL ASSOCIATES, PA

Practice address

4499 Medical Dr
Suite #190
San Antonio, TX 78229-3735

Phone

(210) 614-3915

Fax

(210) 614-3918

NPI assigned

Jan 10, 2007

Last updated

Apr 25, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Kelly Ann Shy, MHSM

Title

Practice Administrator

Phone

(210) 614-3915

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew Robert Torres, MD, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • San Antonio, TX
  • NPI 1073928859
  NPD
• Robert Paul Johnson, DDS, MSD

  • Oral and Maxillofacial Surgery (Dentist)
  • San Antonio, TX
  • NPI 1780650721
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461542400000",
    "number": "1417006065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4499 MEDICAL DR",
            "address_2": "SUITE #190",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293735",
            "telephone_number": "210-614-3915",
            "fax_number": "210-614-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4499 MEDICAL DR",
            "address_2": "SUITE #190",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293735",
            "telephone_number": "210-614-3915",
            "fax_number": "210-614-3918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAMO MAXILLOFACIAL SURGICAL ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2016-04-25",
        "status": "A",
        "authorized_official_last_name": "SHY",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "210-614-3915",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MHSM"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0014AW",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079997501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alamo Internal Medicine Associates
• Alamo Kidney Health PA
• Alamo Kids Dental PLLC (Alamo Kids Dental)
• Alamo Liver Institute PLLC
• Alamo Lung Institute, PA
• Alamo Med Connection, Inc
• Alamo Medical Billing LLC
• Alamo Mobile Chiropractic Services
• Alamo Mobile Chiropractic, LLC
• Alamo Mobile X Ray & Ekg Services, Inc.

• Oral and Maxillofacial Surgery (Dentist) in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.