Provider Demographics
NPI:1043620586
Name:ALVARADO, STEFANIE MARIE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:STEFANIE
Middle Name:MARIE
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:STEFANIE
Other - Middle Name:MARIE
Other - Last Name:BUTERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4012 CEDAR SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-3520
Mailing Address - Country:US
Mailing Address - Phone:214-528-2336
Mailing Address - Fax:214-528-8436
Practice Address - Street 1:4012 CEDAR SPRINGS RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-3520
Practice Address - Country:US
Practice Address - Phone:214-528-2336
Practice Address - Fax:214-528-8436
Is Sole Proprietor?:No
Enumeration Date:2014-05-06
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical