Provider Demographics
NPI:1699957860
Name:VICTOR F. ALVARADO
Entity type:Organization
Organization Name:VICTOR F. ALVARADO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:F
Authorized Official - Last Name:ALVARADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-922-1163
Mailing Address - Street 1:2310 SW MILITARY DR STE 501
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1407
Mailing Address - Country:US
Mailing Address - Phone:210-922-1163
Mailing Address - Fax:210-922-1776
Practice Address - Street 1:2310 SW MILITARY DR STE 501
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1407
Practice Address - Country:US
Practice Address - Phone:210-922-1163
Practice Address - Fax:210-922-1776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX019650301Medicaid
TX019650301Medicaid