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Organization
CLA SURGICAL ASSISTING
Active
Organization
CLA SURGICAL ASSISTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CECILIO L ALVARADO CFA (OWNER)
(817) 294-7444
Entity
Organization
Contact information
Practice address
2600 SAINT MICHAEL DR, TEXARKANA, TX 75503-2372
(903) 614-1000
Mailing address
PO BOX 11219, FORT WORTH, TX 76110-0219
(817) 294-7444
Taxonomy
Speciality
Code
Description
License number
State
246ZN0300X
Nephrology Specialist/Technologist
Primary
680751
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680751
CFA
TX
Enumeration date
10/24/2006
Last updated
08/22/2020
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