Provider Demographics
NPI:1588132039
Name:ALVAREZ, JENNA CAPRI (PA)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:CAPRI
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:CAPRI
Other - Last Name:CALABRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-645-0967
Mailing Address - Fax:214-645-8382
Practice Address - Street 1:701 TUSCAN DR STE 200
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-3837
Practice Address - Country:US
Practice Address - Phone:972-401-3200
Practice Address - Fax:972-401-3230
Is Sole Proprietor?:No
Enumeration Date:2018-11-02
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA12342363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant