Healthcare Provider Details

I. General information

NPI: 1851587950
Provider Name (Legal Business Name): AVELINO C ALVAREZ, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2007
Last Update Date: 04/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2337 ENVDEAVOR DR.
LAREDO TX
78041
US

IV. Provider business mailing address

2337 ENDEAVOR
LAREDO TX
78041-1970
US

V. Phone/Fax

Practice location:
  • Phone: 956-726-4929
  • Fax: 856-724-6242
Mailing address:
  • Phone: 956-726-4929
  • Fax: 856-724-6242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. AVELINO C ALVAREZ
Title or Position: PRESIDENT
Credential: MD
Phone: 956-726-4929