Provider Demographics
NPI:1740155985
Name:ALVAREZ EXIGA, DANIELA (PTA)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:ALVAREZ EXIGA
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 S INDIO AVE
Mailing Address - Street 2:
Mailing Address - City:PORTALES
Mailing Address - State:NM
Mailing Address - Zip Code:88130-6116
Mailing Address - Country:US
Mailing Address - Phone:575-742-6302
Mailing Address - Fax:
Practice Address - Street 1:5244 114TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-6478
Practice Address - Country:US
Practice Address - Phone:806-705-8819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2187954225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant