Provider Demographics
NPI:1174505887
Name:ALEXANDER, MATHEW THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:MATHEW
Middle Name:THOMAS
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1227 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2313
Mailing Address - Country:US
Mailing Address - Phone:361-883-4323
Mailing Address - Fax:361-883-4324
Practice Address - Street 1:1227 3RD ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2313
Practice Address - Country:US
Practice Address - Phone:361-883-4323
Practice Address - Fax:361-883-4324
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8590207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165317201Medicaid
TX8L0938Medicare PIN