MEDICARE: VANESSA ALVEREZ

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	310400000X	Assisted Living Facility	131501	TX

General Provider Information

NPI Number	:	1205128865
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VANESSA ALVEREZ

Provider Business Mailing Address
First Line	:	5557 BLUFFMAN DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75241-3312
Country	:	US
Telephone Number	:	214-484-4941
Fax Number	:

Provider Business Practice Location Address
First Line	:	5557 BLUFFMAN DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75241-3312
Country	:	US
Telephone Number	:	214-484-4941
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. VANESSA ALVEREZ
Credential	:
Telephone Number	:	214-484-4941

Provider Enumeration Date	:	05/13/2011
Last Update Date	:	05/13/2011

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Directions to “VANESSA ALVEREZ ” Practice Location

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