Provider Demographics
NPI:1659659944
Name:MCSWEENEY, ALEX RAY
Entity Type:Individual
Prefix:MR
First Name:ALEX
Middle Name:RAY
Last Name:MCSWEENEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2229 AVENUE A
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-4510
Mailing Address - Country:US
Mailing Address - Phone:214-543-4606
Mailing Address - Fax:
Practice Address - Street 1:2229 AVENUE A
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-4510
Practice Address - Country:US
Practice Address - Phone:214-543-4606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-03
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications