Healthcare Provider Details

I. General information

NPI: 1700711280
Provider Name (Legal Business Name): ALEXIS SUTTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5016 S US HIGHWAY 75
DENISON TX
75020-4584
US

IV. Provider business mailing address

4835 LBJ FWY STE 900
DALLAS TX
75244-6001
US

V. Phone/Fax

Practice location:
  • Phone: 903-416-4000
  • Fax:
Mailing address:
  • Phone: 469-420-5544
  • Fax: 866-284-2475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: