Provider Demographics
NPI:1386697332
Name:EVELINA V. ALCALEN, MD PA
Entity type:Organization
Organization Name:EVELINA V. ALCALEN, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EVELINA
Authorized Official - Middle Name:V
Authorized Official - Last Name:ALCALEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-284-8222
Mailing Address - Street 1:4375 BOOTH CALLOWAY RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-8362
Mailing Address - Country:US
Mailing Address - Phone:817-284-8222
Mailing Address - Fax:817-595-5718
Practice Address - Street 1:4375 BOOTH CALLOWAY RD
Practice Address - Street 2:SUITE 207
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8359
Practice Address - Country:US
Practice Address - Phone:817-284-8222
Practice Address - Fax:817-595-5718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6254207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH93353Medicare UPIN