Provider Demographics
NPI:1790920155
Name:ALVAREZ, JESUS MANUEL (CPO)
Entity Type:Individual
Prefix:MR
First Name:JESUS
Middle Name:MANUEL
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4500 SOUTH LANCASTER ROAD
Mailing Address - Street 2:ATTN: PROSTHETICS (549/121)
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216
Mailing Address - Country:US
Mailing Address - Phone:214-857-0551
Mailing Address - Fax:214-857-0549
Practice Address - Street 1:4500 SOUTH LANCASTER ROAD
Practice Address - Street 2:ATTN: PROSTHETICS (549/121)
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216
Practice Address - Country:US
Practice Address - Phone:214-857-0551
Practice Address - Fax:214-857-0549
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist