Healthcare Provider Details

I. General information

NPI: 1104813609
Provider Name (Legal Business Name): HAROLD E ALEXANDER JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 11/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

741 N ALAMEDA BLVD SUITE 3
LAS CRUCES NM
88005-2172
US

IV. Provider business mailing address

205 W BOUTZ RD BLDG 1
LAS CRUCES NM
88005-3259
US

V. Phone/Fax

Practice location:
  • Phone: 575-522-0399
  • Fax: 575-522-1866
Mailing address:
  • Phone: 575-532-7000
  • Fax: 575-532-7006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number84-3
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: