Healthcare Provider Details

I. General information

NPI: 1922238914
Provider Name (Legal Business Name): NORBERTO ALVAREZ, JR.,M.D.,PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2009
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: DR. NORBERTO ALVAREZ JR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 956-723-0039