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General NPI Number Information
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NPI Number | 1013850759
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Entity Type | Individual
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Provider Name | MISS ALEXANDRIA OCTAVIA ACEVES
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Gender | Female
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Dates
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Enumeration Date | 04/09/2026
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Last Update Date | 04/09/2026
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Provider Practice Location Address
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Address Line | 2501 N BLACKWELDER AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73106-1402
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Country | US
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Telephone | 405-208-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 9009 HUNTING GREEN CT
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City | FORT WORTH
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State | TX
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Zip | 76134-5503
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Country | US
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Telephone | 817-627-4686
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | OK
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