Provider Demographics
NPI:1306219662
Name:ALVIN CLINICA FAMILIAR, INC
Entity Type:Organization
Organization Name:ALVIN CLINICA FAMILIAR, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MENA CANTERO
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:832-831-8925
Mailing Address - Street 1:7400 HARWIN DR STE 319
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2094
Mailing Address - Country:US
Mailing Address - Phone:832-831-8925
Mailing Address - Fax:832-581-3624
Practice Address - Street 1:7400 HARWIN DR STE 319
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2094
Practice Address - Country:US
Practice Address - Phone:832-831-8925
Practice Address - Fax:832-581-3624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-09
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129563261QH0100X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Multi-Specialty