Provider Demographics
NPI:1164982450
Name:DUKHAN, ALEKSANDRA
Entity Type:Individual
Prefix:
First Name:ALEKSANDRA
Middle Name:
Last Name:DUKHAN
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 1:1715 MCCULLOUGH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-4046
Mailing Address - Country:US
Mailing Address - Phone:210-225-5323
Mailing Address - Fax:210-225-7505
Practice Address - Street 1:1715 MCCULLOUGH AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-4046
Practice Address - Country:US
Practice Address - Phone:210-225-5323
Practice Address - Fax:210-225-7505
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT3616207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine