MEDICARE: DR. ALEXANDER F MACDONALD LSCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	104095	TX

General Provider Information

NPI Number	:	1013904580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDER F MACDONALD LSCSW

Provider Business Mailing Address
First Line	:	18700 W LAKE HOUSTON PKWY STE A102
Second Line	:
City	:	ATASCOCITA
State	:	TX
Zip	:	77346-3350
Country	:	US
Telephone Number	:	913-967-9039
Fax Number	:

Provider Business Practice Location Address
First Line	:	18700 W LAKE HOUSTON PKWY STE A102
Second Line	:
City	:	ATASCOCITA
State	:	TX
Zip	:	77346-3350
Country	:	US
Telephone Number	:	913-967-9039
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	03/25/2024

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