Healthcare Provider Details

I. General information

NPI: 1568130177
Provider Name (Legal Business Name): IRVIN EDUARDO OLVERA ALVAREZ PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 S HAMPTON RD
DALLAS TX
75208-5617
US

IV. Provider business mailing address

2701 S HAMPTON RD STE 100
DALLAS TX
75224-2368
US

V. Phone/Fax

Practice location:
  • Phone: 888-478-8432
  • Fax: 469-629-1179
Mailing address:
  • Phone: 972-704-8248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number61178472
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number70127
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: