Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 118233 | TX |
NPI | 1003408865 |
---|---|
Provider Name | Austi Marie Alvarez |
First Address | Corpus Christi, TX 78404-2609 |
Second Address | Alice, TX 78332-4822 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2021 |
Last Update Date | 03/02/2021 |