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NPI Code Detail

MEDICARE: ALEX MCCOLLOSTER

MEDICARE: ALEX MCCOLLOSTER
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
1207Q00000XFamily Medicine PhysicianT3821TX

General Provider Information

NPI Number : 1619472040
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEX MCCOLLOSTER
Provider Business Mailing Address
First Line : 6101 BLUE LAGOON DR STE 200
Second Line :
City : MIAMI
State : FL
Zip : 33126-3168
Country : US
Telephone Number : 361-887-0584
Fax Number : 361-887-0586
Provider Business Practice Location Address
First Line : 5846 WOOLDRIDGE RD
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78414-2402
Country : US
Telephone Number : 361-994-8979
Fax Number : 361-994-8966
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2018
Last Update Date : 04/06/2026

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Directions to “ ALEX MCCOLLOSTER ” Practice Location

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