Healthcare Provider Details

I. General information

NPI: 1649200650
Provider Name (Legal Business Name): JULIAN FERNANDO ALVAREZ-ARROYAVE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 11/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 W OCEAN BLVD SUITE 104
LOS FRESNOS TX
78566-3667
US

IV. Provider business mailing address

324 W OCEAN BLVD SUITE 104
LOS FRESNOS TX
78566-3667
US

V. Phone/Fax

Practice location:
  • Phone: 956-233-2163
  • Fax: 956-233-2165
Mailing address:
  • Phone: 956-233-2163
  • Fax: 956-233-2165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberL9998
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: