Healthcare Provider Details

I. General information

NPI: 1255293015
Provider Name (Legal Business Name): ALEXIS HOAGLAND MED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 VILLAGE CENTER CIR STE 150
LAS VEGAS NV
89134-0597
US

IV. Provider business mailing address

342 NEWCASTLE BRIDGE CT
LAS VEGAS NV
89138-1546
US

V. Phone/Fax

Practice location:
  • Phone: 702-899-5810
  • Fax: 702-899-5855
Mailing address:
  • Phone: 307-220-1971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4366
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: