Provider Demographics
NPI:1134129760
Name:ALVAREZ, SONIA M (MD)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:M
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SONIA
Other - Middle Name:M
Other - Last Name:ALVAREZ-ESCUDERO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5902 ANNUNCIATION ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-2158
Mailing Address - Country:US
Mailing Address - Phone:504-899-9633
Mailing Address - Fax:504-885-0441
Practice Address - Street 1:4300 HOUMA BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2932
Practice Address - Country:US
Practice Address - Phone:504-455-2771
Practice Address - Fax:504-885-0441
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13869R207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1189430Medicaid
BA7236981OtherD E A
01-01783OtherUNITED HEALTHCARE
7191280OtherAETNA
LA1189430Medicaid
BA7236981OtherD E A