Healthcare Provider Details

I. General information

NPI: 1154212066
Provider Name (Legal Business Name): ALEX ALEJANDRO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 N COMMERCE CTR STE 2.201
MCALLEN TX
78501-3185
US

IV. Provider business mailing address

PO BOX 531968
HARLINGEN TX
78553-1968
US

V. Phone/Fax

Practice location:
  • Phone: 833-887-4863
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1365026
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: