Basic Information
| Provider Information | |||||||||
| NPI: | 1003383050 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HPA MEDICAL MANAGEMENT, LLC | ||||||||
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| OtherOrganizationName: | ALAMO SUPPORTIVE CARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3021 LORNA RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | VESTAVIA HILLS | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352164500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2055337216 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3201 CHERRY RIDGE ST STE C313 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782304826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104442244 | ||||||||
| FaxNumber: | 2104441144 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2018 | ||||||||
| LastUpdateDate: | 06/08/2022 | ||||||||
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| AuthorizedOfficialLastName: | ENGLISH | ||||||||
| AuthorizedOfficialFirstName: | NORMA | ||||||||
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| AuthorizedOfficialTitleorPosition: | HOSPICE DIVISION PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2055337216 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| NPICertificationDate: | 06/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QH0002X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | Hospice and Palliative Medicine |
ID Information
| ID | Type | State | Issuer | Description | 3955775 | 05 | TX | MEDICAID |