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NPI Code Detail

MEDICARE: MISS ALEXANDRIA OCTAVIA ACEVES

MEDICARE: MISS ALEXANDRIA OCTAVIA ACEVES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician AssistantOK
2363AS0400XSurgical Physician AssistantTX
3390200000XStudent in an Organized Health Care Education/Training ProgramOK

General Provider Information

NPI Number : 1013850759
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ALEXANDRIA OCTAVIA ACEVES
Provider Business Mailing Address
First Line : 9009 HUNTING GREEN CT
Second Line :
City : FORT WORTH
State : TX
Zip : 76134-5503
Country : US
Telephone Number : 817-627-4686
Fax Number :
Provider Business Practice Location Address
First Line : 2501 N BLACKWELDER AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-1402
Country : US
Telephone Number : 405-208-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2026
Last Update Date : 04/09/2026

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Directions to “ MISS ALEXANDRIA OCTAVIA ACEVES ” Practice Location

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