Provider Demographics
NPI:1477518611
Name:NEJEMIE ALTER, M.D., P.A.
Entity Type:Organization
Organization Name:NEJEMIE ALTER, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEJEMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-814-8055
Mailing Address - Street 1:PO BOX 61034
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78466-1034
Mailing Address - Country:US
Mailing Address - Phone:361-814-8055
Mailing Address - Fax:361-814-8066
Practice Address - Street 1:1001 3RD ST
Practice Address - Street 2:SUITE 7
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2356
Practice Address - Country:US
Practice Address - Phone:361-814-8055
Practice Address - Fax:361-814-8066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK17712080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176795601Medicaid
TX176795601Medicaid
TXG37794Medicare UPIN