Provider Demographics
NPI:1548581697
Name:ALVARADO, DIANA JANETT (PA-C)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:JANETT
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1672 INDEPENDENCE DR STE 310
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-3982
Mailing Address - Country:US
Mailing Address - Phone:830-730-5025
Mailing Address - Fax:830-730-4207
Practice Address - Street 1:723 HILL COUNTRY DR STE B
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-6043
Practice Address - Country:US
Practice Address - Phone:830-792-5800
Practice Address - Fax:830-896-2625
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60178663363A00000X, 363AM0700X
TXPA06559363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical