MEDICARE: JOHN E ALEXANDER MD

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	2085R0202X	Diagnostic Radiology Physician	G3107	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	112506	OTHER	TX	CHIP-SUPERIOR HEALTH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194785022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN E ALEXANDER MD

Provider Business Mailing Address
First Line	:	PO BOX 3926
Second Line	:
City	:	SAN ANGELO
State	:	TX
Zip	:	76902-3926
Country	:	US
Telephone Number	:	325-658-3576
Fax Number	:	325-658-7737

Provider Business Practice Location Address
First Line	:	3308 FOSTER ST
Second Line	:
City	:	SAN ANGELO
State	:	TX
Zip	:	76903-9314
Country	:	US
Telephone Number	:	325-658-3576
Fax Number	:	325-658-7737

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

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	07/08/2007

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Directions to “ JOHN E ALEXANDER MD” Practice Location

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