Provider Demographics
NPI:1770290587
Name:ALVAREZ, KIMBERLY AMBER LAU (PA-C)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:AMBER LAU
Last Name:ALVAREZ
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17510 W GRAND PKWY S STE 420
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2173
Mailing Address - Country:US
Mailing Address - Phone:832-308-3470
Mailing Address - Fax:832-308-3471
Practice Address - Street 1:17510 W GRAND PKWY S STE 420
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2173
Practice Address - Country:US
Practice Address - Phone:832-308-3470
Practice Address - Fax:832-308-3471
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-01
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA18064363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant