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General NPI Number Information
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NPI Number | 1306219662
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Entity Type | Organization
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Legal Business Name | ALVIN CLINICA FAMILIAR, INC
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Dates
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Enumeration Date | 11/09/2015
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Last Update Date | 07/06/2016
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Provider Practice Location Address
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Address Line | 7400 HARWIN DR STE 319
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City | HOUSTON
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State | TX
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Zip | 77036-2094
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Country | US
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Telephone | 832-831-8925
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Fax | 832-581-3624
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Provider Business Mailing Address
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Address Line | 7400 HARWIN DR STE 319
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City | HOUSTON
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State | TX
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Zip | 77036-2094
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Country | US
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Telephone | 832-831-8925
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Fax | 832-581-3624
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MR. ALVIN MENA CANTERO
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Credential | F.N.P
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Telephone | 832-831-8925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | AP129563
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP129563
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License Number State | TX
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