Healthcare Provider Details

I. General information

NPI: 1700616596
Provider Name (Legal Business Name): MARISOL ALVARADO LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2024
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2106 TREASURE HILLS BLVD
HARLINGEN TX
78550-8736
US

IV. Provider business mailing address

2106 TREASURE HILLS BLVD
HARLINGEN TX
78550-8736
US

V. Phone/Fax

Practice location:
  • Phone: 956-366-4500
  • Fax: 956-291-9889
Mailing address:
  • Phone: 956-366-4500
  • Fax: 956-291-9889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number217038
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: