Provider Demographics
NPI:1659444933
Name:ALEXANDER, STEFANI P (PAC)
Entity Type:Individual
Prefix:MS
First Name:STEFANI
Middle Name:P
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7777 FOREST LN
Mailing Address - Street 2:SUITE C 833
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2584
Mailing Address - Country:US
Mailing Address - Phone:972-566-4591
Mailing Address - Fax:972-566-6679
Practice Address - Street 1:7777 FOREST LANE
Practice Address - Street 2:C833
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230
Practice Address - Country:US
Practice Address - Phone:214-566-4591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA01690363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS92882Medicare UPIN