MEDICARE: JEROMEE CAMERON ALEXANDER PT

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	2251X0800X	Orthopedic Physical Therapist	1193338	TX
2	225100000X	Physical Therapist	PT1193338	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	829T15	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1942298484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEROMEE CAMERON ALEXANDER PT

Provider Business Mailing Address
First Line	:	115 FM 2453 STE D
Second Line	:
City	:	ROYSE CITY
State	:	TX
Zip	:	75189-7037
Country	:	US
Telephone Number	:	469-209-6870
Fax Number	:	694-340-0007

Provider Business Practice Location Address
First Line	:	115 FM 2453 STE D
Second Line	:
City	:	ROYSE CITY
State	:	TX
Zip	:	75189-7037
Country	:	US
Telephone Number	:	972-771-8111
Fax Number	:

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

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	11/14/2023

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