| Alamo Primary Care Of Potranco Pllc | |
|
12047 Potranco Rd, Ste 105 San Antonio TX 78253 | |
| (210) 753-0744 | |
| Not Available |
| Full Name | Alamo Primary Care Of Potranco Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 12047 Potranco Rd,, San Antonio, Texas |
| Authorized Official Name and Position | Vishal Nemarugommula (MD) |
| Authorized Official Contact | 2107530744 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alamo Primary Care Of Potranco Pllc Po Box 654421 Dallas TX 75265-4421 Ph: (210) 571-1338 | Alamo Primary Care Of Potranco Pllc 12047 Potranco Rd, Ste 105 San Antonio TX 78253 Ph: (210) 753-0744 |
| NPI Number | 1912601907 |
|---|---|
| Provider Enumeration Date | 03/27/2023 |
| Last Update Date | 03/28/2024 |
| Medicare PECOS PAC ID | 2365807443 |
|---|---|
| Medicare Enrollment ID | O20230721001277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912601907 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Vishal Nemarugommula |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194982777 PECOS PAC ID: 2961673306 Enrollment ID: I20150108002096 |
| Provider Name | Felicity Melodee Guajardo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023470366 PECOS PAC ID: 0941639272 Enrollment ID: I20200824002639 |
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