Healthcare Provider Details

I. General information

NPI: 1346496825
Provider Name (Legal Business Name): ESTHER LEE HARGRAVE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2008
Last Update Date: 08/04/2020
Certification Date: 08/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 B ST STE 200
ANCHORAGE AK
99503-5933
US

IV. Provider business mailing address

16811 SOUTHWEST FWY STE 300
SUGAR LAND TX
77479-4728
US

V. Phone/Fax

Practice location:
  • Phone: 907-375-3355
  • Fax: 907-375-3351
Mailing address:
  • Phone: 907-281-2760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberS7447
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMEDS8060
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD037569
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMED8060
License Number StateAK
# 5
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number8060
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: