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NPI Code Detail

MEDICARE: BRENT T ALFORD MD PA

MEDICARE: BRENT T ALFORD MD PA
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
1207T00000XNeurological Surgery PhysicianK1969TX

General Provider Information

NPI Number : 1306194188
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRENT T ALFORD MD PA
Provider Business Mailing Address
First Line : 1356 OLD CREEK DR
Second Line :
City : TYLER
State : TX
Zip : 75703-7642
Country : US
Telephone Number : 903-534-0809
Fax Number : 903-939-9149
Provider Business Practice Location Address
First Line : 1356 OLD CREEK DR
Second Line :
City : TYLER
State : TX
Zip : 75703-7642
Country : US
Telephone Number : 903-534-0809
Fax Number : 903-939-9149
Authorized Official
Title or Position : PRESIDENT
Name : DR. BRENT T ALFORD
Credential : MD
Telephone Number : 214-663-4958
Provider Enumeration Date : 08/27/2012
Last Update Date : 08/27/2012

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Directions to “BRENT T ALFORD MD PA ” Practice Location

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