Provider Demographics
NPI:1952774523
Name:MAESE, ALEX (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:MAESE
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3022 TRAWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-4312
Mailing Address - Country:US
Mailing Address - Phone:915-855-8550
Mailing Address - Fax:833-478-1530
Practice Address - Street 1:3022 TRAWOOD DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-4312
Practice Address - Country:US
Practice Address - Phone:915-855-8550
Practice Address - Fax:833-478-1530
Is Sole Proprietor?:No
Enumeration Date:2015-11-04
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129160363LP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care