Provider Demographics
NPI:1336460559
Name:ALANIS, JUAN JOSE JR
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:JOSE
Last Name:ALANIS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2517 LOU ANN LN
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-3318
Mailing Address - Country:US
Mailing Address - Phone:956-425-4538
Mailing Address - Fax:
Practice Address - Street 1:2517 LOU ANN LN
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-3318
Practice Address - Country:US
Practice Address - Phone:956-425-4538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00359363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical