MEDICARE: JENNIFER ALVARADO P.A.-C

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	363A00000X	Physician Assistant	PA03938	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PA03938	OTHER	TX	PHYSICIAN ASSISTANT PERMI

General Provider Information

NPI Number	:	1770605578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ALVARADO P.A.-C

Provider Business Mailing Address
First Line	:	PO BOX 13203
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79913-3203
Country	:	US
Telephone Number	:	915-217-2793
Fax Number	:	915-584-8546

Provider Business Practice Location Address
First Line	:	6151 DEW DR STE 410
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-3912
Country	:	US
Telephone Number	:	915-217-2793
Fax Number	:	915-584-8546

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

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	09/16/2024

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