Healthcare Provider Details

I. General information

NPI: 1114099561
Provider Name (Legal Business Name): JORGE ALVAREZ CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 03/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1309 E RIDGE RD STE 3
MCALLEN TX
78503-1518
US

IV. Provider business mailing address

PO BOX 6746
MCALLEN TX
78502-6746
US

V. Phone/Fax

Practice location:
  • Phone: 956-631-7202
  • Fax: 956-631-3026
Mailing address:
  • Phone: 956-682-4151
  • Fax: 956-682-4154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number733927
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: