Provider Demographics
NPI:1922287721
Name:ALEXANDER, SUMMER D (OTR)
Entity Type:Individual
Prefix:
First Name:SUMMER
Middle Name:D
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 PAZA DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-5107
Mailing Address - Country:US
Mailing Address - Phone:972-288-3703
Mailing Address - Fax:
Practice Address - Street 1:434 PAZA DR
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-5107
Practice Address - Country:US
Practice Address - Phone:972-288-3703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106358225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist