Provider Demographics
NPI:1730547985
Name:ALVAREZ, LOURDES GUADALUPE (CPNP-PC)
Entity type:Individual
Prefix:
First Name:LOURDES
Middle Name:GUADALUPE
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S. ZARAGOSA
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907
Mailing Address - Country:US
Mailing Address - Phone:915-790-5715
Mailing Address - Fax:915-860-4186
Practice Address - Street 1:1344 BACKUS ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-6605
Practice Address - Country:US
Practice Address - Phone:915-319-5472
Practice Address - Fax:915-860-4186
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-03
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132790363LP0200X
TX619113261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health