Provider Demographics
NPI:1114099561
Name:ALVAREZ, JORGE (CRNA)
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6746
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-6746
Mailing Address - Country:US
Mailing Address - Phone:956-682-4151
Mailing Address - Fax:956-682-4154
Practice Address - Street 1:1309 E RIDGE RD STE 3
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1518
Practice Address - Country:US
Practice Address - Phone:956-631-7202
Practice Address - Fax:956-631-3026
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX733927367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX187395203Medicaid
TX89488UOtherBCBS
TX88921UOtherBCBS
TX187395202Medicaid
TX88921UOtherBCBS
TX8F9556Medicare PIN