MEDICARE: THERESE MARIE ALVAREZ

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	363LP2300X	Primary Care Nurse Practitioner	1051505	TX

General Provider Information

NPI Number	:	1912877218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESE MARIE ALVAREZ

Provider Business Mailing Address
First Line	:	847 E ASHBY PL APT 654
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-2075
Country	:	US
Telephone Number	:	210-797-4638
Fax Number	:

Provider Business Practice Location Address
First Line	:	17503 LA CANTERA PKWY # 104-404
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78257-8207
Country	:	US
Telephone Number	:	210-802-1661
Fax Number	:	210-579-6710

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

Provider Enumeration Date	:	11/11/2025
Last Update Date	:	12/02/2025

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