MEDICARE: DR. IMAD ALWAN 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	207RC0000X	Cardiovascular Disease Physician	L9068	TX
2	207RC0000X	Cardiovascular Disease Physician	0101259539	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	752616977029	OTHER	TX	TRICARE
2	8V5490	OTHER	TX	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	752616977073	OTHER	TX	TRICARE

General Provider Information

NPI Number	:	1811931512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IMAD ALWAN MD

Provider Business Mailing Address
First Line	:	801 N BEDELL AVE
Second Line	:
City	:	DEL RIO
State	:	TX
Zip	:	78840-4112
Country	:	US
Telephone Number	:	830-290-6028
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 N BEDELL AVE
Second Line	:
City	:	DEL RIO
State	:	TX
Zip	:	78840-4112
Country	:	US
Telephone Number	:	830-290-6028
Fax Number	:

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

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	07/26/2024

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Directions to “ DR. IMAD ALWAN MD” Practice Location

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