Healthcare Provider Details

I. General information

NPI: 1689134892
Provider Name (Legal Business Name): ANA BEATRIZ FADHEL ALVAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17150 EL CAMINO REAL
HOUSTON TX
77058-2738
US

IV. Provider business mailing address

17150 EL CAMINO REAL
HOUSTON TX
77058-2738
US

V. Phone/Fax

Practice location:
  • Phone: 713-500-5663
  • Fax: 713-500-5663
Mailing address:
  • Phone: 713-500-5663
  • Fax: 713-500-5663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberT4916
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: