Healthcare Provider Details

I. General information

NPI: 1013923739
Provider Name (Legal Business Name): ALEXIS A HARRIS SNEAD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 04/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 NE 97TH ST STE 600
OKLAHOMA CITY OK
73114-6302
US

IV. Provider business mailing address

14275 MIDWAY RD STE 400
ADDISON TX
75001-3676
US

V. Phone/Fax

Practice location:
  • Phone: 405-842-2061
  • Fax:
Mailing address:
  • Phone: 405-842-2061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number2001-45
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number27151
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: