MEDICARE: ALFREDO IBARRA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MT137600	TX

General Provider Information

NPI Number	:	1134916901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALFREDO IBARRA

Provider Business Mailing Address
First Line	:	104 MARTINGALE
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78041-2231
Country	:	US
Telephone Number	:	956-534-0835
Fax Number	:

Provider Business Practice Location Address
First Line	:	6423 MCPHERSON RD STE 14
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78041-6144
Country	:	US
Telephone Number	:	956-229-9161
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2025
Last Update Date	:	04/23/2025

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Directions to “ ALFREDO IBARRA ” Practice Location

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