Healthcare Provider Details
I. General information
NPI: 1114840030
Provider Name (Legal Business Name): ALEXANDER MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2680 S VAL VISTA DR STE 131
GILBERT AZ
85295-2155
US
IV. Provider business mailing address
2680 S VAL VISTA DR STE 131
GILBERT AZ
85295-2155
US
V. Phone/Fax
- Phone: 480-299-0589
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
THOMAS
ALEXANDER
Title or Position: OWNER/NP
Credential:
Phone: 480-299-0589