Healthcare Provider Details

I. General information

NPI: 1598911380
Provider Name (Legal Business Name): REGINALD ANDER ALEXANDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2008
Last Update Date: 07/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 N MACARTHUR BLVD SUITE 203
IRVING TX
75038-6497
US

IV. Provider business mailing address

1414 S GRAND AVE STE 123
LOS ANGELES CA
90015-3071
US

V. Phone/Fax

Practice location:
  • Phone: 972-255-5588
  • Fax: 972-573-3807
Mailing address:
  • Phone: 213-455-8448
  • Fax: 213-745-8922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberP7237
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: