Provider Demographics
NPI:1952307845
Name:ALEXANDER, TRACE LAWRENCE (FNP,DC)
Entity Type:Individual
Prefix:DR
First Name:TRACE
Middle Name:LAWRENCE
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:FNP,DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 118917
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75011-8917
Mailing Address - Country:US
Mailing Address - Phone:972-899-9797
Mailing Address - Fax:469-771-0268
Practice Address - Street 1:5425 W SPRING CREEK PKWY STE 115
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-4333
Practice Address - Country:US
Practice Address - Phone:972-899-9797
Practice Address - Fax:469-771-0268
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126290363LF0000X, 363LF0000X
TX6832DC111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX504136OtherMEDICARE PTAN PLANO (FNP)
TX504135OtherMEDICARE PTAN ADDISON (FNP)
TXOA371OtherMEDICARE PTAN (CHIRO)