Healthcare Provider Details

I. General information

NPI: 1235073461
Provider Name (Legal Business Name): ALEXIS TORRES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1881 CAMPUS COMMONS DR STE 500
RESTON VA
20191-1572
US

IV. Provider business mailing address

128 BERN ST
READING PA
19601-1249
US

V. Phone/Fax

Practice location:
  • Phone: 703-391-9680
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: