Provider Demographics
NPI:1982969150
Name:MARTINEZ ALVARADO, ALEJANDRO
Entity type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:
Last Name:MARTINEZ ALVARADO
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 1:24506 BIRDIE RDG
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-7822
Mailing Address - Country:US
Mailing Address - Phone:210-687-6645
Mailing Address - Fax:
Practice Address - Street 1:4416 RAMSGATE ST STE 202
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-1670
Practice Address - Country:US
Practice Address - Phone:210-690-5555
Practice Address - Fax:210-694-5066
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX281451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice