Healthcare Provider Details

I. General information

NPI: 1710692298
Provider Name (Legal Business Name): ALICE COST CONTAINMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2023
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 EAST MAIN STREET
ALICE TX
78332
US

IV. Provider business mailing address

102 EAST MAIN STREET
ALICE TX
78332
US

V. Phone/Fax

Practice location:
  • Phone: 361-756-0446
  • Fax: 361-271-1415
Mailing address:
  • Phone: 361-756-0446
  • Fax: 361-271-1415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: HUMBERTO SAAVEDRA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 361-756-0446