Provider Demographics
NPI:1811086119
Name:ALVARADO, VICTOR F
Entity type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:F
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 1:2310 SW MILITARY DR
Mailing Address - Street 2:STE. 501
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1407
Mailing Address - Country:US
Mailing Address - Phone:210-922-1163
Mailing Address - Fax:210-922-1776
Practice Address - Street 1:2310 SW MILITARY DR
Practice Address - Street 2:STE. 501
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1407
Practice Address - Country:US
Practice Address - Phone:210-922-1163
Practice Address - Fax:210-922-1776
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0196503-01Medicaid