Healthcare Provider Details

I. General information

NPI: 1730383324
Provider Name (Legal Business Name): NORBERTO ALVAREZ JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 04/27/2020
Certification Date: 04/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1419 CLARK BLVD
LAREDO TX
78040-3417
US

IV. Provider business mailing address

1419 CLARK BLVD
LAREDO TX
78040-3417
US

V. Phone/Fax

Practice location:
  • Phone: 956-723-0039
  • Fax: 956-723-6608
Mailing address:
  • Phone: 956-723-0039
  • Fax: 956-723-6608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License NumberM7824
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberM7824
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: