Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | N3439 | TX |
NPI | 1003913617 |
---|---|
Provider Name | Tahira Palmer Alves |
First Address | San Antonio, TX 78216-6256 |
Second Address | San Antonio, TX 78251-3818 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2006 |
Last Update Date | 07/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
206694605 | (05) | TX |
P01092754 | MEDICARE RAILROAD (01) | TX |