Provider Demographics
NPI:1649625450
Name:ROYSTON, ALEXA (DO)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:
Last Name:ROYSTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3509 SPECTRUM BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-9703
Mailing Address - Country:US
Mailing Address - Phone:972-772-9600
Mailing Address - Fax:972-772-9601
Practice Address - Street 1:3509 SPECTRUM BLVD STE B
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-9703
Practice Address - Country:US
Practice Address - Phone:972-772-9600
Practice Address - Fax:972-772-9601
Is Sole Proprietor?:No
Enumeration Date:2016-04-29
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390200000X
TXS4379208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program