=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023665684
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LANCHASICA ALEXANDER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/19/2019
-----------------------------------------------------
Last Update Date | 11/06/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7601 PRESTON RD
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75024-3214
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-303-4300
-----------------------------------------------------
Fax | 469-867-5449
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 845347
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75284-5347
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-645-0624
-----------------------------------------------------
Fax | 214-645-0078
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | AP142356
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------