Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 10693 | TX |
NPI | 1124107495 |
---|---|
Provider Name | Dr. Alvin J Elsik JR. |
First Address | San Antonio, TX 78205-2409 |
Second Address | San Antonio, TX 78202-3265 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 09/07/2007 |