Provider Demographics
NPI:1306368436
Name:ALEXANDER'S CHILDREN SERVICES, INC.
Entity Type:Organization
Organization Name:ALEXANDER'S CHILDREN SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PEDIATRIC NURSE PRACTITIO
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:E
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:SR
Authorized Official - Credentials:BS, BSN, RN, CPNP
Authorized Official - Phone:409-983-1882
Mailing Address - Street 1:2128 PROCTER ST
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77640-6752
Mailing Address - Country:US
Mailing Address - Phone:409-983-1882
Mailing Address - Fax:409-983-1823
Practice Address - Street 1:2128 PROCTER ST
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77640-6752
Practice Address - Country:US
Practice Address - Phone:409-983-1882
Practice Address - Fax:409-983-1823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP103698261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care