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1376599209

NPI Code Detail

MEDICARE: DR. VINU ALEXANDER MD

MEDICARE: DR. VINU 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	207P00000X	Emergency Medicine Physician	99-1	NM
2	207Q00000X	Family Medicine Physician	K 9973	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	TXB110470	OTHER	TX	MEDICARE PTAN

General Provider Information

NPI Number	:	1376599209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VINU ALEXANDER MD

Provider Business Mailing Address
First Line	:	1500 S MAIN ST
Second Line	:	1500 MAIN ST
City	:	FT WORTH
State	:	TX
Zip	:	76104-4917
Country	:	US
Telephone Number	:	817-702-3431
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 S MAIN ST
Second Line	:	1500 MAIN ST
City	:	FT WORTH
State	:	TX
Zip	:	76104-4917
Country	:	US
Telephone Number	:	505-240-0883
Fax Number	:

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

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	06/04/2016

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Directions to “ DR. VINU ALEXANDER MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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