Provider Demographics
NPI:1275656274
Name:ALEXUS DUTCHESS MEDICAL CONSULANT
Entity Type:Organization
Organization Name:ALEXUS DUTCHESS MEDICAL CONSULANT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-360-5261
Mailing Address - Street 1:3167 GUADALOUPE
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-6727
Mailing Address - Country:US
Mailing Address - Phone:469-360-5261
Mailing Address - Fax:972-572-9808
Practice Address - Street 1:3167 GUDALOUPE
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75054
Practice Address - Country:US
Practice Address - Phone:469-360-5261
Practice Address - Fax:972-572-9808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies