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General NPI Number Information
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NPI Number | 1922773571
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Entity Type | Individual
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Provider Name | ALEXANDRA BLAIR PATEK FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/14/2021
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Last Update Date | 08/14/2021
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Provider Practice Location Address
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Address Line | 405 N LAMAR BLVD STE 110
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City | AUSTIN
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State | TX
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Zip | 78703-2103
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Country | US
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Telephone | 737-255-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 13409 LARRYS LN
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City | MANCHACA
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State | TX
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Zip | 78652-4524
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Country | US
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Telephone | 361-772-2047
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1050452
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License Number State | TX
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