Provider Demographics
NPI:1316098544
Name:ALVAREZ, EDUARDO L (MD)
Entity type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:L
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 JACK MILLER RD STE 9
Mailing Address - Street 2:
Mailing Address - City:VILLE PLATTE
Mailing Address - State:LA
Mailing Address - Zip Code:70586-5600
Mailing Address - Country:US
Mailing Address - Phone:337-363-7228
Mailing Address - Fax:337-363-6903
Practice Address - Street 1:504 JACK MILLER RD
Practice Address - Street 2:STE 9
Practice Address - City:VILLE PLATTE
Practice Address - State:LA
Practice Address - Zip Code:70586-5600
Practice Address - Country:US
Practice Address - Phone:337-363-7228
Practice Address - Fax:337-363-6903
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA023295174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1541028Medicaid
LA5A636Medicare ID - Type Unspecified
LA1541028Medicaid