Provider Demographics
NPI:1881951614
Name:ALVARADO, JOSE ALBERTO (CO)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:ALBERTO
Last Name:ALVARADO
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2465 BATAAN MEMORIAL W
Mailing Address - Street 2:SUITE # 3
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88012-5039
Mailing Address - Country:US
Mailing Address - Phone:575-556-9568
Mailing Address - Fax:575-556-9569
Practice Address - Street 1:2465 BATAAN MEMORIAL W
Practice Address - Street 2:SUITE # 3
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88012-5039
Practice Address - Country:US
Practice Address - Phone:575-556-9568
Practice Address - Fax:575-556-9569
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC26337335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier