Provider Demographics
NPI:1811129612
Name:ALVAREZ, EDDUINA E (LMT)
Entity type:Individual
Prefix:MS
First Name:EDDUINA
Middle Name:E
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4968 ARROYO CHAMISA RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3718
Mailing Address - Country:US
Mailing Address - Phone:505-974-6135
Mailing Address - Fax:
Practice Address - Street 1:4968 ARROYO CHAMISA RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-3718
Practice Address - Country:US
Practice Address - Phone:505-974-6135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM6334174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist