Healthcare Provider Details

I. General information

NPI: 1871740001
Provider Name (Legal Business Name): JULIAN F. ALVAREZ, MD. PEDIATRIC CLINCIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 11/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 W. OCEAN BLVD. SUITE 104
LOS FRESNOS TX
78566
US

IV. Provider business mailing address

324 W OCEAN BLVD STE 104
LOS FRESNOS TX
78566-3668
US

V. Phone/Fax

Practice location:
  • Phone: 956-496-8442
  • Fax:
Mailing address:
  • Phone: 956-233-2163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JULIAN ALVAREZ
Title or Position: OWNER
Credential: M.D.
Phone: 956-233-2163