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General NPI Number Information
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NPI Number | 1558500041
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Entity Type | Organization
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Legal Business Name | ALEXANDER KELLEY MEDICALLY SUPERVISED WEIGHT LOSS PROGRAM
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Dates
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Enumeration Date | 02/07/2009
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Last Update Date | 02/07/2009
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Provider Practice Location Address
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Address Line | 1415 S VOSS RD SUITE 200
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City | HOUSTON
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State | TX
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Zip | 77057-1086
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Country | US
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Telephone | 713-781-5566
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Fax | 713-554-1837
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Provider Business Mailing Address
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Address Line | 1415 S VOSS RD SUITE 200
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City | HOUSTON
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State | TX
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Zip | 77057-1086
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Country | US
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Telephone | 713-781-5566
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Fax | 713-554-1837
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Authorized Official
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Title or Position | PARTNER
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Name | VICTORIA L ALEXANDER
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Credential | MD
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Telephone | 713-781-5566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RB0002X
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Taxonomy Name | Obesity Medicine (Internal Medicine) Physician
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License Number | H9747
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License Number State | TX
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