Provider Demographics
NPI:1790537348
Name:ALVAREZ, MATEO (OD)
Entity Type:Individual
Prefix:DR
First Name:MATEO
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 N LOOP 1604 W STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-2230
Mailing Address - Country:US
Mailing Address - Phone:210-822-9800
Mailing Address - Fax:
Practice Address - Street 1:2810 N LOOP 1604 W STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-2230
Practice Address - Country:US
Practice Address - Phone:210-822-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program