Provider Demographics
NPI:1437858503
Name:ALVARADO, VICTOR NEFTALI (LMT)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:NEFTALI
Last Name:ALVARADO
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 HICKORY LN
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-7370
Mailing Address - Country:US
Mailing Address - Phone:936-714-7860
Mailing Address - Fax:
Practice Address - Street 1:25 HICKORY LN
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-7370
Practice Address - Country:US
Practice Address - Phone:936-714-7860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT136126225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist