Provider Demographics
NPI:1538686902
Name:PITTS, ALEXANDRIA TRISTINE
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:TRISTINE
Last Name:PITTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2815 GUADALUPE ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-3771
Mailing Address - Country:US
Mailing Address - Phone:925-683-9853
Mailing Address - Fax:
Practice Address - Street 1:2815 GUADALUPE ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-3771
Practice Address - Country:US
Practice Address - Phone:925-683-9853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program