MEDICARE: ALEXANDER DE JESUS HADDED 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
1	363AM0700X	Medical Physician Assistant	MA066384	PA
2	363AM0700X	Medical Physician Assistant	PA12285	TX
3	363AM0700X	Medical Physician Assistant	PA67143	CA

General Provider Information

NPI Number	:	1518442649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER DE JESUS HADDED PA

Provider Business Mailing Address
First Line	:	6445 FM 1463 RD STE 140
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-4028
Country	:	US
Telephone Number	:	860-301-9604
Fax Number	:

Provider Business Practice Location Address
First Line	:	6445 FM 1463 RD STE 140
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-4028
Country	:	US
Telephone Number	:	346-202-6671
Fax Number	:	346-202-6676

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

Provider Enumeration Date	:	09/25/2018
Last Update Date	:	02/19/2026

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