Healthcare Provider Details

I. General information

NPI: 1760842389
Provider Name (Legal Business Name): MARIA GABRIELA HURTADO ALVARADO PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2016
Last Update Date: 06/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4422 PACK SADDLE PASS STE 102
AUSTIN TX
78745
US

IV. Provider business mailing address

4422 PACK SADDLE PASS STE 102
AUSTIN TX
78745-1644
US

V. Phone/Fax

Practice location:
  • Phone: 480-560-1353
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number37680
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: