Provider Demographics
NPI:1770752966
Name:SANDERS, ALEXIS CHARMELLE
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:CHARMELLE
Last Name:SANDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23222 KINGSLAND BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-3033
Mailing Address - Country:US
Mailing Address - Phone:281-693-0084
Mailing Address - Fax:281-693-0093
Practice Address - Street 1:23222 KINGSLAND BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-3033
Practice Address - Country:US
Practice Address - Phone:281-693-0084
Practice Address - Fax:281-693-0093
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05157363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant