Healthcare Provider Details

I. General information

NPI: 1114097524
Provider Name (Legal Business Name): AVELINO C ALVAREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: AVELINO C ALVAREZ PA

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2337 ENDEAVOR
LAREDO TX
78041-1970
US

IV. Provider business mailing address

2337 ENDEAVOR
LAREDO TX
78041-1970
US

V. Phone/Fax

Practice location:
  • Phone: 956-726-4929
  • Fax: 956-724-6242
Mailing address:
  • Phone: 956-726-4929
  • Fax: 956-724-6242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberH6731
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: