Organization
ELEVEN-TWELVE COMPANY
Active
Other names
Kansas Cardiac Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAUL ALVAREZ D.C. (ADMINISTRATOR)
(316) 267-0159
Entity
Organization
Contact information
Practice address
1144 N SAINT FRANCIS ST, WICHITA, KS 67214-2814
(316) 267-0159
(316) 267-3601
Mailing address
1144 N SAINT FRANCIS ST, WICHITA, KS 67214-2814
(316) 267-0159
(316) 267-3601
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
04-23137
KS
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100083020A
—
KS
05
—
100158960B
—
KS
05
—
100197170A
—
KS
05
—
100236410C
—
KS
05
—
100402610C
—
KS
01
—
1073595815
NPI
—
01
—
1366520686
NPI
—
01
—
1588646236
NPI
—
01
—
1710969548
NPI
—
01
—
1811979644
NPI
—
Enumeration date
05/02/2007
Last updated
01/12/2010
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