Provider Demographics
NPI:1639283427
Name:ALEXANDER, CORA L (MD)
Entity Type:Individual
Prefix:
First Name:CORA
Middle Name:L
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 HALL RD
Mailing Address - Street 2:
Mailing Address - City:SEAGOVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75159-2916
Mailing Address - Country:US
Mailing Address - Phone:972-287-7474
Mailing Address - Fax:972-228-7746
Practice Address - Street 1:116 HALL RD
Practice Address - Street 2:
Practice Address - City:SEAGOVILLE
Practice Address - State:TX
Practice Address - Zip Code:75159-2916
Practice Address - Country:US
Practice Address - Phone:972-287-7474
Practice Address - Fax:972-228-7746
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0131207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX178058703Medicaid
TX8K7378Medicare PIN
TXC12689Medicare UPIN