MEDICARE: DR. PETER ALEXANDER ALIVIZATOS 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	146D00000X	Personal Emergency Response Attendant	G7614	TX

General Provider Information

NPI Number	:	1790906337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER ALEXANDER ALIVIZATOS MD

Provider Business Mailing Address
First Line	:	3600 GASTON AVENUE
Second Line	:	404 BARNETT TOWER
City	:	DALLAS
State	:	TX
Zip	:	75246-1804
Country	:	US
Telephone Number	:	214-824-6718
Fax Number	:	214-821-3760

Provider Business Practice Location Address
First Line	:	3600 GASTON AVENUE
Second Line	:	404 BARNETT TOWER
City	:	DALLAS
State	:	TX
Zip	:	75246-1804
Country	:	US
Telephone Number	:	214-824-6718
Fax Number	:	214-821-3760

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

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	07/08/2007

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