Healthcare Provider Details

I. General information

NPI: 1417868514
Provider Name (Legal Business Name): SAPHIRE ALEXANDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 C AVE
CACHE OK
73527-5807
US

IV. Provider business mailing address

1569 NW QUANAH RD
CACHE OK
73527-4539
US

V. Phone/Fax

Practice location:
  • Phone: 580-781-1849
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: