Provider Demographics
NPI:1912565193
Name:JENKINS, ALEXANDRA STEELE (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:STEELE
Last Name:JENKINS
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 1:2017 HOLLY LEAF DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-0923
Mailing Address - Country:US
Mailing Address - Phone:512-924-9679
Mailing Address - Fax:
Practice Address - Street 1:909 E SOUTHEAST LOOP 323 STE 110
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-9675
Practice Address - Country:US
Practice Address - Phone:903-531-2850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT9929207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology