=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891881363
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ELMER ALGER, MD, PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/04/2006
-----------------------------------------------------
Last Update Date | 10/23/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1518 10TH ST
-----------------------------------------------------
City | WICHITA FALLS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-723-2400
-----------------------------------------------------
Fax | 940-723-2406
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1518 10TH ST
-----------------------------------------------------
City | WICHITA FALLS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-723-2400
-----------------------------------------------------
Fax | 940-723-2406
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MS. JO ANN LABRIE
-----------------------------------------------------
Credential | LVN
-----------------------------------------------------
Telephone | 940-723-2400
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | K3060
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------