MEDICARE: PATRICIA R ALVARADO

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	235Z00000X	Speech-Language Pathologist	116325	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710657846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA R ALVARADO

Provider Business Mailing Address
First Line	:	170 LAS BRISAS BLVD
Second Line	:
City	:	KYLE
State	:	TX
Zip	:	78640-6075
Country	:	US
Telephone Number	:	512-268-8505
Fax Number	:

Provider Business Practice Location Address
First Line	:	170 LAS BRISAS BLVD
Second Line	:
City	:	KYLE
State	:	TX
Zip	:	78640-6075
Country	:	US
Telephone Number	:	512-268-8505
Fax Number	:

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

Provider Enumeration Date	:	09/20/2021
Last Update Date	:	09/20/2021

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Directions to “ PATRICIA R ALVARADO ” Practice Location

Language	Start Address	Practice Location

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