Healthcare Provider Details

I. General information

NPI: 1245439140
Provider Name (Legal Business Name): ALVAREZ VISION SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 09/02/2025
Certification Date: 03/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 W MAIN ST
LOOGOOTEE IN
47553-1506
US

IV. Provider business mailing address

403 WALKER ST
LOOGOOTEE IN
47553-1424
US

V. Phone/Fax

Practice location:
  • Phone: 812-295-3163
  • Fax: 812-901-6627
Mailing address:
  • Phone: 260-415-0267
  • Fax: 812-901-6623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number18002795A
License Number StateIN

VIII. Authorized Official

Name: DR. MICHAEL M ALVAREZ
Title or Position: PRESIDENT, OPTOMETRIST
Credential: OD
Phone: 260-415-0267