Individual provider Active NPI

Leticia Alvarez, PAC

  • Medical Physician Assistant
  • Pharr, TX
National Provider Identifier
1174579064
Registry record updated Aug 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA04269 Issued in TX
Practice address
807 N. Cage
Pharr, TX 78577
Phone
(956) 283-1889
Fax
(956) 283-7014
NPI assigned
May 25, 2006
Last updated
Aug 24, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA04269 TX Primary

Addresses

Primary practice location

807 N. Cage
Pharr, TX 78577

Mailing address

807 N. Cage
Pharr, TX 78577
Phone (956) 283-1889

Other identifiers 1

IdentifierTypeStateIssuer
PA04269OtherTXTEXAS STATE MEDICAL LIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060630000057 TX Practitioner - Physician Assistant 6103838503 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Goodside Health Medical, PLLC CurrentSince Sep 10, 2023 Accepting new patients
Goodside Health Medical, PLLC CurrentSince Sep 10, 2023 Accepting new patients
Goodside Health Medical, PLLC Past Accepting new patients
B Healthy Dietary Consultants Past Accepting new patients
Edinburg Pediatric Network LLC PastSince Oct 24, 2011 Accepting new patients

Locations

1500 N Cummings Dr
Alvarado, TX 76009
Phone (817) 783-6863

2101 Faro Dr
Austin, TX 78741

555 S Major Dr
Beaumont, TX 77707

1701 River Run
Ste 302
Ft Worth, TX 76107
Phone (512) 857-1222

6315 Winkleman Rd
Houston, TX 77083

2727 Military Pkwy
Mesquite, TX 75149

1403 N Saint Marys St
San Antonio, TX 78215

6070 Babcock Rd
San Antonio, TX 78240

727 E Hildebrand Ave
San Antonio, TX 78212

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251072000000",
    "number": "1174579064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 N. CAGE",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "78577",
            "telephone_number": "956-283-1889",
            "fax_number": "956-283-7014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 N. CAGE",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "78577",
            "telephone_number": "956-283-1889",
            "fax_number": "956-283-7014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVAREZ",
        "first_name": "LETICIA",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2009-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA04269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE MEDICAL LIC",
            "identifier": "PA04269",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pharr, TX

Sources for this page

Verify at the official NPI Registry.