Healthcare Provider Details

I. General information

NPI: 1598577959
Provider Name (Legal Business Name): ANU XANDY ALEXANDER MATHEW CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANU XANDY ALEXANDER

II. Dates (important events)

Enumeration Date: 01/23/2025
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 W 15TH ST STE 107
PLANO TX
75075-7789
US

IV. Provider business mailing address

2812 GOOSEBERRY DR
PLANO TX
75074-2044
US

V. Phone/Fax

Practice location:
  • Phone: 972-964-7773
  • Fax:
Mailing address:
  • Phone: 469-554-3532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number779589
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP143843
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: