Provider Demographics
NPI:1467477836
Name:ALVARADO, BRENDA A (OD)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:A
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10230 FOWLER RD
Mailing Address - Street 2:
Mailing Address - City:ATASCOSA
Mailing Address - State:TX
Mailing Address - Zip Code:78002-5785
Mailing Address - Country:US
Mailing Address - Phone:210-622-9316
Mailing Address - Fax:
Practice Address - Street 1:2310 SW MILITARY DR
Practice Address - Street 2:STE. 501
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1407
Practice Address - Country:US
Practice Address - Phone:210-922-1163
Practice Address - Fax:210-922-1776
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6884T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist