Provider Demographics
NPI:1336926815
Name:ALEGRIA, THOMAS G
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:G
Last Name:ALEGRIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4014 N 22ND ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-4101
Mailing Address - Country:US
Mailing Address - Phone:361-589-1121
Mailing Address - Fax:956-992-1090
Practice Address - Street 1:4014 N 22ND ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4101
Practice Address - Country:US
Practice Address - Phone:361-589-1121
Practice Address - Fax:956-992-1090
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92589390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program