Provider Demographics
NPI:1710633953
Name:ALVAREZ VARGAS, GERARDO (DPT)
Entity Type:Individual
Prefix:
First Name:GERARDO
Middle Name:
Last Name:ALVAREZ VARGAS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 MECCA DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-2209
Mailing Address - Country:US
Mailing Address - Phone:951-260-9975
Mailing Address - Fax:
Practice Address - Street 1:5100 JOHN D RYAN BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-3527
Practice Address - Country:US
Practice Address - Phone:262-665-9089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist