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General NPI Number Information
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NPI Number | 1215997259
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Entity Type | Individual
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Provider Name | ELIAZAR G ALVAREZ MD
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Gender | Male
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 07/30/2024
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Provider Practice Location Address
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Address Line | 3920 W WHEATLAND RD STE 152
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City | DALLAS
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State | TX
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Zip | 75237-3404
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Country | US
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Telephone | 214-467-0432
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Fax | 214-467-0635
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Provider Business Mailing Address
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Address Line | 4400 OAK PARK LN
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City | FORT WORTH
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State | TX
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Zip | 76109-9534
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | K9983
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G67483
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License Number State | CA
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