Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 135938 | TX |
NPI | 1528567104 |
---|---|
Provider Name | Maria Guadalupe Alvarado |
First Address | Fort Worth, TX 76137-6129 |
Second Address | Dallas, TX 75203-1201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2018 |
Last Update Date | 08/02/2018 |