Healthcare Provider Details

I. General information

NPI: 1093332702
Provider Name (Legal Business Name): ARMANDO ALVAREZ NNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2020
Last Update Date: 01/31/2022
Certification Date: 01/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4520 WILLIAMS BLVD APT W266
KENNER LA
70065-5536
US

IV. Provider business mailing address

180 W ESPLANADE AVE
KENNER LA
70065-2467
US

V. Phone/Fax

Practice location:
  • Phone: 956-355-6159
  • Fax:
Mailing address:
  • Phone: 956-355-6159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number1061391
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number200458
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: