Provider Demographics
NPI:1528133121
Name:ALVAREZ, RAMON JR (OD)
Entity type:Individual
Prefix:
First Name:RAMON
Middle Name:
Last Name:ALVAREZ
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8838M VISCOUNT
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925
Mailing Address - Country:US
Mailing Address - Phone:915-592-4151
Mailing Address - Fax:915-592-4259
Practice Address - Street 1:8838M VISCOUNT
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925
Practice Address - Country:US
Practice Address - Phone:915-592-4151
Practice Address - Fax:915-592-4259
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2015-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX02106T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0196008-01Medicaid
1121500001Medicare ID - Type Unspecified
TX0196008-01Medicaid