Provider Demographics
NPI:1841205309
Name:KAZARAS, ALEXANDRA (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:KAZARAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LEXI
Other - Middle Name:
Other - Last Name:KAZARAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5608 ZUNI RD SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-2926
Mailing Address - Country:US
Mailing Address - Phone:505-262-6560
Mailing Address - Fax:505-265-7045
Practice Address - Street 1:7317 CENTRAL AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-2015
Practice Address - Country:US
Practice Address - Phone:505-262-6560
Practice Address - Fax:505-265-7045
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2000-218207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine