Provider Demographics
NPI:1922238914
Name:NORBERTO ALVAREZ, JR.,M.D.,PA
Entity Type:Organization
Organization Name:NORBERTO ALVAREZ, JR.,M.D.,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NORBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:956-723-0039
Mailing Address - Street 1:1419 CLARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-3417
Mailing Address - Country:US
Mailing Address - Phone:956-723-0039
Mailing Address - Fax:956-723-6608
Practice Address - Street 1:1419 CLARK BLVD
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040-3417
Practice Address - Country:US
Practice Address - Phone:956-723-0039
Practice Address - Fax:956-723-6608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7824204C00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX208484002Medicaid
TX208483202Medicaid
TX208483205Medicaid
TX208484001Medicaid
TX208483204Medicaid
TX208483205Medicaid
TX208484002Medicaid