Provider Demographics
NPI:1780944843
Name:ALFARO, VICTOR (LOA)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:ALFARO
Suffix:
Gender:M
Credentials:LOA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2267 TRAWOOD DR STE C1
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-3027
Mailing Address - Country:US
Mailing Address - Phone:915-599-8883
Mailing Address - Fax:915-599-8885
Practice Address - Street 1:2267 TRAWOOD DR STE C1
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-3027
Practice Address - Country:US
Practice Address - Phone:915-599-8883
Practice Address - Fax:915-599-8885
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter