Provider Demographics
NPI:1851587950
Name:AVELINO C ALVAREZ, M.D., P.A.
Entity Type:Organization
Organization Name:AVELINO C ALVAREZ, M.D., P.A.
Other - Org Name:THE CHILDREN'S CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AVELINO
Authorized Official - Middle Name:C
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-726-4929
Mailing Address - Street 1:2337 ENDEAVOR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-1970
Mailing Address - Country:US
Mailing Address - Phone:956-726-4929
Mailing Address - Fax:856-724-6242
Practice Address - Street 1:2337 ENVDEAVOR DR.
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041
Practice Address - Country:US
Practice Address - Phone:956-726-4929
Practice Address - Fax:856-724-6242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6731208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1303216-01Medicaid
TX1303216-07Medicaid
TX1303216-03Medicaid
TX1303216-05Medicaid
TX1303216-03Medicaid