Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 34409 | TX |
Y | 213EG0000X | General Practice | 34409 | TX |
NPI | 1003823964 |
---|---|
Provider Name | Alejandro Alonso |
First Address | Socorro, TX 79927-4627 |
Second Address | Socorro, TX 79927-4627 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 29/01/2022 |