Healthcare Provider Details

I. General information

NPI: 1831455641
Provider Name (Legal Business Name): ELIZABETH THOMAS ALEXANDER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2012
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PELHAM PARKWAY SOUTH
BRONX NY
10461
US

IV. Provider business mailing address

6621 FANNIN ST STE AB2210
HOUSTON TX
77030-2358
US

V. Phone/Fax

Practice location:
  • Phone: 718-918-5700
  • Fax:
Mailing address:
  • Phone: 832-828-3660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberQ5749
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: