Provider Demographics
NPI:1972290526
Name:PINILLA, ALVARO (PA)
Entity Type:Individual
Prefix:
First Name:ALVARO
Middle Name:
Last Name:PINILLA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 WALNUT COVE LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-8163
Mailing Address - Country:US
Mailing Address - Phone:832-275-2224
Mailing Address - Fax:
Practice Address - Street 1:12333 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-6205
Practice Address - Country:US
Practice Address - Phone:713-729-7600
Practice Address - Fax:713-729-7603
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1636-P-A363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical