Provider Demographics
NPI:1528268141
Name:ALANIZ, ALFREDO
Entity type:Individual
Prefix:PROF
First Name:ALFREDO
Middle Name:
Last Name:ALANIZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3422 GLASTONBURY DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-2451
Mailing Address - Country:US
Mailing Address - Phone:281-412-3298
Mailing Address - Fax:281-235-4200
Practice Address - Street 1:4711 AIRLINE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77022-3003
Practice Address - Country:US
Practice Address - Phone:713-699-8910
Practice Address - Fax:713-699-8910
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-22
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX361223601Medicaid