Provider Demographics
NPI:1154865574
Name:ALEXANDER, SHEEQUITA
Entity Type:Individual
Prefix:
First Name:SHEEQUITA
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12400 SHADOW CREEK PKWY
Mailing Address - Street 2:APT 1810
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7347
Mailing Address - Country:US
Mailing Address - Phone:601-434-9629
Mailing Address - Fax:
Practice Address - Street 1:12400 SHADOW CREEK PKWY
Practice Address - Street 2:APT 1810
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7347
Practice Address - Country:US
Practice Address - Phone:601-434-9629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132658363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily