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General NPI Number Information
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NPI Number | 1154447993
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Entity Type | Individual
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Provider Name | GUSTAVO ALEJANDRO ALVAREZ-PAIVA M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 08/19/2021
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Provider Practice Location Address
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Address Line | 1800 PLAZA DR
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City | BEDFORD
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State | TX
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Zip | 76021-6013
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Country | US
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Telephone | 817-310-4490
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Fax | 817-310-4491
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Provider Business Mailing Address
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Address Line | PO BOX 35629
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City | DALLAS
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State | TX
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Zip | 75235-0629
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Country | US
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Telephone | 214-424-2213
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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 | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 43780
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 2003024385
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License Number State | MO
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