Provider Demographics
NPI:1427321686
Name:ALVARADO ALLIANCE LLC
Entity type:Organization
Organization Name:ALVARADO ALLIANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVARADO
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:432-607-3243
Mailing Address - Street 1:2025 BRENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-5061
Mailing Address - Country:US
Mailing Address - Phone:432-607-3243
Mailing Address - Fax:432-607-3298
Practice Address - Street 1:600 INTERSTATE 20 EAST
Practice Address - Street 2:
Practice Address - City:STANTON
Practice Address - State:TX
Practice Address - Zip Code:79782
Practice Address - Country:US
Practice Address - Phone:432-607-3243
Practice Address - Fax:432-607-3298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-20
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX666342363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty