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General NPI Number Information
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NPI Number | 1114635497
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Entity Type | Individual
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Provider Name | CLARISSA ALVAREZ PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 11/07/2022
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Last Update Date | 11/29/2022
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Provider Practice Location Address
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Address Line | 112 HERFF RD STE 310
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City | BOERNE
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State | TX
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Zip | 78006-2750
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Country | US
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Telephone | 830-431-9660
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Fax |
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Provider Business Mailing Address
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Address Line | 112 HERFF RD STE 310
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City | BOERNE
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State | TX
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Zip | 78006-2750
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Country | US
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Telephone | 979-239-7164
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 1369997
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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