MEDICARE: DR. ALEXANDER ENOS TESHON MD

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	207P00000X	Emergency Medicine Physician	MD490852	PA
2	207P00000X	Emergency Medicine Physician	V2295	TX
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1316687361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDER ENOS TESHON MD

Provider Business Mailing Address
First Line	:	22999 HIGHWAY 59 N
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77339-4412
Country	:	US
Telephone Number	:	281-348-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	22999 HIGHWAY 59 N
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77339-4412
Country	:	US
Telephone Number	:	281-348-8000
Fax Number	:

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

Provider Enumeration Date	:	03/29/2022
Last Update Date	:	12/17/2025

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