Healthcare Provider Details

I. General information

NPI: 1386445997
Provider Name (Legal Business Name): AMY ALVAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2025
Last Update Date: 03/20/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 E NAVAJO DR SUITE 1300
HOBBS NM
88240
US

IV. Provider business mailing address

630 E LLANO DR
HOBBS NM
88240-4012
US

V. Phone/Fax

Practice location:
  • Phone: 575-201-8494
  • Fax:
Mailing address:
  • Phone: 575-201-8494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH3731
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: