Basic Information
Provider Information
NPI: 1275516510
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALEXANDER
FirstName: STEVEN
MiddleName: DONALD
NamePrefix: MR.
NameSuffix:  
Credential: PA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 908 S. EVANS ST
Address2:  
City: UVALDE
State: TX
PostalCode: 788016034
CountryCode: US
TelephoneNumber: 8302785604
FaxNumber: 8302781836
Practice Location
Address1: 700 S FRIO
Address2:  
City: CAMP WOOD
State: TX
PostalCode: 788330455
CountryCode: US
TelephoneNumber: 8305976424
FaxNumber: 8305976427
Other Information
ProviderEnumerationDate: 11/21/2005
LastUpdateDate: 03/29/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XPA00648TXY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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