Provider Demographics
NPI:1417980160
Name:BUTKEVICH, ALEXANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:BUTKEVICH
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 1:12234 SHADOW CREEK PKWY STE 6106
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7338
Mailing Address - Country:US
Mailing Address - Phone:713-436-6653
Mailing Address - Fax:713-436-6365
Practice Address - Street 1:12234 SHADOW CREEK PKWY STE 6106
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7338
Practice Address - Country:US
Practice Address - Phone:713-436-6653
Practice Address - Fax:713-436-6365
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8293207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine