Provider Demographics
NPI:1568564888
Name:ALVAREZ, LILIA BERTHA (OD)
Entity Type:Individual
Prefix:DR
First Name:LILIA
Middle Name:BERTHA
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1346 N. LEE TREVINO DR
Mailing Address - Street 2:STE 114
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-6438
Mailing Address - Country:US
Mailing Address - Phone:915-772-0777
Mailing Address - Fax:915-779-0780
Practice Address - Street 1:1346 N. LEE TREVINO DR
Practice Address - Street 2:STE 114
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-6438
Practice Address - Country:US
Practice Address - Phone:915-772-0777
Practice Address - Fax:915-772-0780
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3753T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0195315-01Medicaid
TX0195315-01Medicaid
TX00E84PMedicare PIN
TX4306530001Medicare NSC