Provider Demographics
NPI:1760038434
Name:ALIVIO, ARTHUR MAR OSORES
Entity Type:Individual
Prefix:
First Name:ARTHUR MAR
Middle Name:OSORES
Last Name:ALIVIO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 MANCOS DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-7085
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:412 N DALTON ST
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TX
Practice Address - Zip Code:76511-4332
Practice Address - Country:US
Practice Address - Phone:254-527-3371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-17
Last Update Date:2019-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2146998225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant