Provider Demographics
NPI:1821253311
Name:MOSCOSO-AGOSTO, ALEJANDRA (MD)
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:MOSCOSO-AGOSTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALEJANDRA
Other - Middle Name:
Other - Last Name:MOSCOSO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8745 GARY BURNS DR
Mailing Address - Street 2:SUITE 160-133
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-2540
Mailing Address - Country:US
Mailing Address - Phone:214-994-6951
Mailing Address - Fax:
Practice Address - Street 1:405 N MCDONALD ST STE B
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-3911
Practice Address - Country:US
Practice Address - Phone:972-542-4144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI69678-20207Q00000X
FLME141461207Q00000X
TXP1368207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine