Provider Demographics
NPI:1396208005
Name:ARCE, ALEXANDRA BERNADETTE (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:BERNADETTE
Last Name:ARCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BRUNO
Other - Middle Name:
Other - Last Name:ARCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 2168
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76113-2168
Mailing Address - Country:US
Mailing Address - Phone:682-207-8017
Mailing Address - Fax:
Practice Address - Street 1:200 S GENEVA ST
Practice Address - Street 2:
Practice Address - City:BRECKENRIDGE
Practice Address - State:TX
Practice Address - Zip Code:76424-4799
Practice Address - Country:US
Practice Address - Phone:817-368-0320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA292751207Q00000X
390200000X
TXT7156207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine