Provider Demographics
NPI:1740277649
Name:ALEXANDER, CHARLOTTE BLACKMORE (MD)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:BLACKMORE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14090 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 130
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3677
Mailing Address - Country:US
Mailing Address - Phone:281-265-4263
Mailing Address - Fax:281-265-4265
Practice Address - Street 1:14090 SOUTHWEST FWY
Practice Address - Street 2:SUITE 130
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3677
Practice Address - Country:US
Practice Address - Phone:281-265-4263
Practice Address - Fax:281-265-4265
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7084207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Z962OtherMEDICARE
TXC12674OtherUPIN