Provider Demographics
NPI:1275155830
Name:ALVARADO, RAQUEL (RN)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 CLEAR LAKE LOOP
Mailing Address - Street 2:
Mailing Address - City:POTEET
Mailing Address - State:TX
Mailing Address - Zip Code:78065-4752
Mailing Address - Country:US
Mailing Address - Phone:210-454-9497
Mailing Address - Fax:
Practice Address - Street 1:8000 W IH 10
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-3802
Practice Address - Country:US
Practice Address - Phone:210-524-7747
Practice Address - Fax:210-469-4026
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-17
Last Update Date:2020-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX701987163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health