Provider Demographics
NPI:1922364850
Name:ALVAREZ, MARIA O (LMT)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:O
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 WILDFLOWER DR
Mailing Address - Street 2:SUITE 611
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-3062
Mailing Address - Country:US
Mailing Address - Phone:979-774-4343
Mailing Address - Fax:
Practice Address - Street 1:3100 WILDFLOWER DR
Practice Address - Street 2:SUITE 611
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-3062
Practice Address - Country:US
Practice Address - Phone:979-774-4343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT108376225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist