Provider Demographics
NPI:1104887348
Name:ALVARADO, NIVEA I (MD)
Entity type:Individual
Prefix:DR
First Name:NIVEA
Middle Name:I
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3004 S W S YOUNG DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-2023
Mailing Address - Country:US
Mailing Address - Phone:254-634-7337
Mailing Address - Fax:254-634-2592
Practice Address - Street 1:3004 S W S YOUNG DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-2023
Practice Address - Country:US
Practice Address - Phone:254-634-7337
Practice Address - Fax:254-634-2592
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ1611208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXJ73EOtherBCBS
TX97421OtherSWHP
TX97421OtherSWHP