Individual provider · NPI-1

Juan Alba

Contractor · San Antonio, TX

NPI number1235539008
StatusActive
Last updated in NPPESAug 29, 2014

Details

NPI
1235539008
Entity type
Individual (NPI-1)
Name
Juan Alba
Sex
Male
Sole proprietor
Yes
Enumeration date
Aug 29, 2014
Last updated
Aug 29, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
171W00000X Contractor–TXYes

Practice location

2806 Fredericksburg Rd Ste 104
San Antonio, TX 78201-4705

Phone 210-278-2324 · Fax 210-305-4202

Mailing address

2806 Fredericksburg Rd Ste 104
San Antonio, TX 78201-4705

Phone 210-278-2324 · Fax 210-305-4202

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