Provider Demographics
NPI:1700843034
Name:ALVAREZ, SERGIO R (MD)
Entity Type:Individual
Prefix:MR
First Name:SERGIO
Middle Name:R
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1004 QUINTA ANTIGUA LN
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-2039
Mailing Address - Country:US
Mailing Address - Phone:915-533-8499
Mailing Address - Fax:915-544-4929
Practice Address - Street 1:2311 N MESA ST
Practice Address - Street 2:BLDG E
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3575
Practice Address - Country:US
Practice Address - Phone:915-533-8499
Practice Address - Fax:915-544-4929
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7798207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136708802Medicaid
TX00FX96Medicare ID - Type UnspecifiedMEDICARE
TXB20885Medicare UPIN