Provider Demographics
NPI:1992748586
Name:RESTREPO, ALVARO (MD)
Entity type:Individual
Prefix:DR
First Name:ALVARO
Middle Name:
Last Name:RESTREPO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75392-0001
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:1901 S 2ND ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1271
Practice Address - Country:US
Practice Address - Phone:956-687-5150
Practice Address - Fax:956-687-9546
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3093207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8R1535OtherBLUE CROSS OF TEXAS
TX150865703Medicaid
TX150865702Medicaid
TX8G6424Medicare PIN
TX150865703Medicaid
TX8A6051Medicare PIN
TX8A0116Medicare PIN
H20292Medicare UPIN