Basic Information
| Provider Information | |||||||||
| NPI: | 1538474556 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALEXANDER | ||||||||
| FirstName: | NIKKI | ||||||||
| MiddleName: | LOUISE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARM D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21738 HARDY OAK | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782584863 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104968050 | ||||||||
| FaxNumber: | 2104968970 | ||||||||
| Practice Location | |||||||||
| Address1: | 21738 HARDY OAK | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782584863 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104968050 | ||||||||
| FaxNumber: | 2104968970 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2010 | ||||||||
| LastUpdateDate: | 08/13/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 0202207513 | VA | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.