Provider Demographics
NPI:1740888106
Name:ALVARADO, NOEL ABRAHAM
Entity type:Individual
Prefix:
First Name:NOEL
Middle Name:ABRAHAM
Last Name:ALVARADO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2429 BISSONNET ST STE 544
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-1451
Mailing Address - Country:US
Mailing Address - Phone:713-292-7870
Mailing Address - Fax:
Practice Address - Street 1:2429 BISSONNET ST STE 544
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-1451
Practice Address - Country:US
Practice Address - Phone:713-292-7870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT121776225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist