=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871845420
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALVARO A CARPIO DDS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/05/2012
-----------------------------------------------------
Last Update Date | 06/01/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11041 SHADOW CREEK PKWY STE 125
-----------------------------------------------------
City | PEARLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77584-7402
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-413-8282
-----------------------------------------------------
Fax | 713-413-8585
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11041 SHADOW CREEK PKWY STE 125
-----------------------------------------------------
City | PEARLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77584-7402
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-361-4641
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0700X
-----------------------------------------------------
Taxonomy Name | Prosthodontics
-----------------------------------------------------
License Number | 28486
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 28486
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------