Provider Demographics
NPI:1871740001
Name:JULIAN F. ALVAREZ, MD. PEDIATRIC CLINCIC
Entity type:Organization
Organization Name:JULIAN F. ALVAREZ, MD. PEDIATRIC CLINCIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-233-2163
Mailing Address - Street 1:324 W OCEAN BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:LOS FRESNOS
Mailing Address - State:TX
Mailing Address - Zip Code:78566-3668
Mailing Address - Country:US
Mailing Address - Phone:956-233-2163
Mailing Address - Fax:
Practice Address - Street 1:323 W. OCEAN BLVD. SUITE 104
Practice Address - Street 2:
Practice Address - City:LOS FRESNOS
Practice Address - State:TX
Practice Address - Zip Code:78566
Practice Address - Country:US
Practice Address - Phone:956-496-8442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-19
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9998208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1649200650OtherNATIONAL PROVIDER IDENTIFIER
TX1649200650OtherNATIONAL PROVIDER IDENTIFIER