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General NPI Number Information
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NPI Number | 1780798975
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Entity Type | Organization
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Legal Business Name | GARY A ALEXANDER DDS PC
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1824 B N VELASCO
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City | ANGLETON
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State | TX
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Zip | 77515
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Country | US
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Telephone | 979-849-0280
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Fax | 979-849-4561
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Provider Business Mailing Address
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Address Line | 109 OAK CREEK LN
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City | LEAUGE CITY
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State | TX
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Zip | 77573
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Country | US
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Telephone | 281-554-6817
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Fax | 281-554-6817
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GARY A ALEXANDER
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Credential | DDS
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Telephone | 979-849-0280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 15282
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License Number State | TX
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