Provider Demographics
NPI:1881153591
Name:ALVAREZ, GUADALUPE (COTA)
Entity type:Individual
Prefix:
First Name:GUADALUPE
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:GUADALUPE
Other - Middle Name:ALVAREZ
Other - Last Name:URBINA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:COTA
Mailing Address - Street 1:1900 S JACKSON RD STE 2
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1589
Mailing Address - Country:US
Mailing Address - Phone:956-630-4400
Mailing Address - Fax:956-630-4447
Practice Address - Street 1:1900 S JACKSON RD STE 2
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1589
Practice Address - Country:US
Practice Address - Phone:956-630-4440
Practice Address - Fax:956-630-4447
Is Sole Proprietor?:No
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX213391224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant