MEDICARE: DR. NIVEA I ALVARADO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	J1611	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	J73E	OTHER	TX	BCBS
2	97421	OTHER	TX	SWHP

General Provider Information

NPI Number	:	1104887348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NIVEA I ALVARADO MD

Provider Business Mailing Address
First Line	:	3004 S W S YOUNG DR
Second Line	:
City	:	KILLEEN
State	:	TX
Zip	:	76542-2023
Country	:	US
Telephone Number	:	254-634-7337
Fax Number	:	254-634-2592

Provider Business Practice Location Address
First Line	:	3004 S W S YOUNG DR
Second Line	:
City	:	KILLEEN
State	:	TX
Zip	:	76542-2023
Country	:	US
Telephone Number	:	254-634-7337
Fax Number	:	254-634-2592

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	07/09/2007

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Directions to “ DR. NIVEA I ALVARADO MD” Practice Location

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