Provider Demographics
NPI:1669167110
Name:DE LOS ANGELES AVALOS, CLAUDIA
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:DE LOS ANGELES AVALOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 TRAVIS AVE
Mailing Address - Street 2:
Mailing Address - City:ALVARADO
Mailing Address - State:TX
Mailing Address - Zip Code:76009-5574
Mailing Address - Country:US
Mailing Address - Phone:817-323-8374
Mailing Address - Fax:817-402-5037
Practice Address - Street 1:902 TRAVIS AVE
Practice Address - Street 2:
Practice Address - City:ALVARADO
Practice Address - State:TX
Practice Address - Zip Code:76009-5574
Practice Address - Country:US
Practice Address - Phone:817-323-8374
Practice Address - Fax:817-402-5037
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health