Organization Active NPI

Alamo Pediatric Eye Center, PLLC

  • Ophthalmology Physician
  • San Antonio, TX
National Provider Identifier
1902596497
Registry record updated Jun 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
ALAMO PEDIATRIC EYE CENTER, PLLC
Practice address
4374 Lockhill Selma Rd Ste 101
San Antonio, TX 78249-3539
Phone
(210) 624-8282
NPI assigned
May 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2023

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

Authorized official

Name
Gwenn Stinnett
Title
Billing Manager
Phone
(828) 551-1157

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

4374 Lockhill Selma Rd Ste 101
San Antonio, TX 78249-3539

Mailing address

4374 Lockhill Selma Rd Ste 101
San Antonio, TX 78249-3539

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230526000330 TX Part B Supplier - Clinic/Group Practice 5799142287 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2314428Alamo Pediatric Eye Center PLLC4374 Lockhill Selma #101, San Antonio, TX 78249Certificate of waiverNov 19, 2026

National Provider Directory

National Provider Directory

Locations

4374 Lockhill Selma Rd
Ste 101
San Antonio, TX 78249
Phone (210) 624-8282

Interoperability endpoints

  • Direct secure messaging: mchharba@alamo.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685836800000",
    "number": "1902596497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4374 LOCKHILL SELMA RD STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782493539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4374 LOCKHILL SELMA RD STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782493539",
            "telephone_number": "210-624-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAMO PEDIATRIC EYE CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-06-04",
        "certification_date": "2023-06-04",
        "status": "A",
        "authorized_official_last_name": "STINNETT",
        "authorized_official_first_name": "GWENN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "828-551-1157"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.