Provider Demographics
NPI:1407690225
Name:ALVAREZ, AARON (PT)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11617 N CENTRAL EXPY STE 140
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3845
Mailing Address - Country:US
Mailing Address - Phone:214-369-4123
Mailing Address - Fax:
Practice Address - Street 1:11617 N CENTRAL EXPY STE 140
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3845
Practice Address - Country:US
Practice Address - Phone:214-369-4123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-25
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3132936225100000X
TX1396239225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist