MEDICARE: DOMINIQUE ALEXANDER

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	101YP2500X	Professional Counselor	90220	TX

General Provider Information

NPI Number	:	1841029592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOMINIQUE ALEXANDER

Provider Business Mailing Address
First Line	:	23015 FM 529 RD STE 200-1051
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77493-5065
Country	:	US
Telephone Number	:	832-296-6955
Fax Number	:

Provider Business Practice Location Address
First Line	:	23015 FM 529 RD STE 200-1051
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77493-5065
Country	:	US
Telephone Number	:	832-296-6955
Fax Number	:

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

Provider Enumeration Date	:	07/31/2024
Last Update Date	:	07/31/2024

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Directions to “ DOMINIQUE ALEXANDER ” Practice Location

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