Provider Demographics
NPI:1982770418
Name:ALVAREZ, JOSE LUIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:LUIS
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1713 WESTON BRENT LN
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-3013
Mailing Address - Country:US
Mailing Address - Phone:915-592-2097
Mailing Address - Fax:915-592-2853
Practice Address - Street 1:1713 WESTON BRENT LN
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-3013
Practice Address - Country:US
Practice Address - Phone:915-592-2097
Practice Address - Fax:915-592-2853
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice