Provider Demographics
NPI:1811991409
Name:ALVAREZ, RAUL (DC)
Entity type:Individual
Prefix:DR
First Name:RAUL
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:766 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:MAIZE
Mailing Address - State:KS
Mailing Address - Zip Code:67101-9587
Mailing Address - Country:US
Mailing Address - Phone:316-617-5245
Mailing Address - Fax:859-201-4918
Practice Address - Street 1:766 PLANTATION ST
Practice Address - Street 2:
Practice Address - City:MAIZE
Practice Address - State:KS
Practice Address - Zip Code:67101-9587
Practice Address - Country:US
Practice Address - Phone:316-768-4918
Practice Address - Fax:859-201-4918
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4892111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS062148OtherBLUE CROSS BLUE SHIELD
KS062148Medicare ID - Type Unspecified