Healthcare Provider Details

I. General information

NPI: 1912305046
Provider Name (Legal Business Name): DELOREAN ALEXANDER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2014
Last Update Date: 03/26/2022
Certification Date: 03/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9055 KATY FWY STE 200
HOUSTON TX
77024-1629
US

IV. Provider business mailing address

4119 JUNIPER MEADOWS LN
HOUSTON TX
77053-4550
US

V. Phone/Fax

Practice location:
  • Phone: 713-461-2915
  • Fax:
Mailing address:
  • Phone: 832-752-7302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP127046
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: