Provider Demographics
NPI:1639766140
Name:ALVA, GEORGE TERRAZAS (FNP)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:TERRAZAS
Last Name:ALVA
Suffix:
Gender:M
Credentials:FNP
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Mailing Address - Street 1:6908 BOOT RANCH RD
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79765-2440
Mailing Address - Country:US
Mailing Address - Phone:432-385-4819
Mailing Address - Fax:432-400-1415
Practice Address - Street 1:4519 N GARFIELD ST STE 1
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-3400
Practice Address - Country:US
Practice Address - Phone:432-219-9200
Practice Address - Fax:432-218-7879
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2022-08-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX1023948363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM66851OtherNEW MEXICO ENDORSEMENT LICENSE