Provider Demographics
NPI:1821018680
Name:PIANTINI ALVAREZ, REBECA E (MD)
Entity Type:Individual
Prefix:
First Name:REBECA
Middle Name:E
Last Name:PIANTINI ALVAREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:556 BLUEBIRD LN
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-4251
Mailing Address - Country:US
Mailing Address - Phone:972-617-6660
Mailing Address - Fax:469-218-0070
Practice Address - Street 1:556 BLUEBIRD LN
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-4251
Practice Address - Country:US
Practice Address - Phone:972-617-6660
Practice Address - Fax:469-218-0070
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG69929208000000X
TXL0512208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G699290Medicaid
TX186986901Medicaid
F32161Medicare UPIN
00G699290Medicare ID - Type Unspecified
TX186986901Medicaid