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NPI Code Detail

MEDICARE: JANIS KAY ALEXANDER P.A.

MEDICARE: JANIS KAY ALEXANDER P.A.
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
1363A00000XPhysician AssistantPA06163TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1825N69OTHERTXBCBS
2PA06163OTHERTXLICENSE

General Provider Information

NPI Number : 1457593337
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANIS KAY ALEXANDER P.A.
Provider Business Mailing Address
First Line : PO BOX 22000
Second Line :
City : SAN ANGELO
State : TX
Zip : 76902-7200
Country : US
Telephone Number : 325-658-1511
Fax Number : 325-481-2166
Provider Business Practice Location Address
First Line : 3502 KNICKERBOCKER RD
Second Line :
City : SAN ANGELO
State : TX
Zip : 76904-7671
Country : US
Telephone Number : 325-658-1511
Fax Number : 325-481-2166
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2009
Last Update Date : 11/03/2016

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