MEDICARE: DAVID ALEXANDER M.ED., L.P.C.

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
1	101YP2500X	Professional Counselor	11719	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114900941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID ALEXANDER M.ED., L.P.C.

Provider Business Mailing Address
First Line	:	901 WALLACE BLVD
Second Line	:	BLDG. 501
City	:	AMARILLO
State	:	TX
Zip	:	79106-1705
Country	:	US
Telephone Number	:	806-349-5653
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 WALLACE BLVD
Second Line	:	BLDG. 501
City	:	AMARILLO
State	:	TX
Zip	:	79106-1705
Country	:	US
Telephone Number	:	806-349-5653
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2005
Last Update Date	:	09/08/2008

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