Provider Demographics
NPI:1952327645
Name:ALEXANDRIA PEDIATRICS, LLC
Entity Type:Organization
Organization Name:ALEXANDRIA PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:YASSER
Authorized Official - Middle Name:M
Authorized Official - Last Name:NAKHLAWI
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:318-487-1477
Mailing Address - Street 1:3311 PRESCOTT RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3900
Mailing Address - Country:US
Mailing Address - Phone:318-487-1477
Mailing Address - Fax:318-442-5814
Practice Address - Street 1:3311 PRESCOTT RD
Practice Address - Street 2:SUITE 210
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3900
Practice Address - Country:US
Practice Address - Phone:318-487-1477
Practice Address - Fax:318-442-5814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty