Provider Demographics
NPI:1174858591
Name:ALVISO, CELIA (RN CPNP PC)
Entity Type:Individual
Prefix:MRS
First Name:CELIA
Middle Name:
Last Name:ALVISO
Suffix:
Gender:F
Credentials:RN CPNP PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-3117
Mailing Address - Country:US
Mailing Address - Phone:210-922-7000
Mailing Address - Fax:210-924-5611
Practice Address - Street 1:7333 BARLITE BLVD STE 380
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1359
Practice Address - Country:US
Practice Address - Phone:210-922-7000
Practice Address - Fax:210-924-5611
Is Sole Proprietor?:No
Enumeration Date:2009-10-04
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX640973363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX208451906Medicaid