Provider Demographics
NPI:1043042310
Name:ALCAZAR, HUMBERTO III
Entity type:Individual
Prefix:
First Name:HUMBERTO
Middle Name:
Last Name:ALCAZAR
Suffix:III
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5728 BURNING TREE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-4106
Mailing Address - Country:US
Mailing Address - Phone:915-304-6790
Mailing Address - Fax:
Practice Address - Street 1:5728 BURNING TREE DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-4106
Practice Address - Country:US
Practice Address - Phone:915-304-6790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-15
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No374U00000XNursing Service Related ProvidersHome Health Aide