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General NPI Number Information
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NPI Number | 1609974989
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Entity Type | Individual
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Provider Name | CEDRIC LEE ALVAREZ DDS
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 11/11/2020
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Provider Practice Location Address
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Address Line | 17230 AUTRY POND STE 115
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City | SAN ANTONIO
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State | TX
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Zip | 78247-2097
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Country | US
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Telephone | 210-396-7667
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Fax | 210-396-7556
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Provider Business Mailing Address
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Address Line | 17230 AUTRY POND STE 115
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City | SAN ANTONIO
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State | TX
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Zip | 78247-2097
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Country | US
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Telephone | 210-396-7667
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Fax | 210-396-7556
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22729
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License Number State | TX
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