Healthcare Provider Details

I. General information

NPI: 1245195734
Provider Name (Legal Business Name): DEANDREA ALANIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 HWY 290 W
ELGIN TX
78621-1463
US

IV. Provider business mailing address

1080 HWY 290 W
ELGIN TX
78621-1463
US

V. Phone/Fax

Practice location:
  • Phone: 512-285-4719
  • Fax:
Mailing address:
  • Phone: 512-285-4719
  • Fax: 866-576-7527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number340441
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: