Provider Demographics
NPI:1720025380
Name:ALVA, BRICK EDUARDO (MD)
Entity Type:Individual
Prefix:
First Name:BRICK
Middle Name:EDUARDO
Last Name:ALVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11738 FM 1960 RD W
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3514
Mailing Address - Country:US
Mailing Address - Phone:713-494-1805
Mailing Address - Fax:
Practice Address - Street 1:11738 FM 1960 RD W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3514
Practice Address - Country:US
Practice Address - Phone:713-494-1805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3140207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAPPLIED FORMedicare ID - Type UnspecifiedAPPLIED FOR