Provider Demographics
NPI:1104083302
Name:ALEXANDER, KIMBERLY PATRICE
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:PATRICE
Last Name:ALEXANDER
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 1:4114 CYPRESS KNEE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77039-3357
Mailing Address - Country:US
Mailing Address - Phone:281-227-7009
Mailing Address - Fax:281-227-7408
Practice Address - Street 1:4114 CYPRESS KNEE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77039-3357
Practice Address - Country:US
Practice Address - Phone:281-227-7009
Practice Address - Fax:281-227-7408
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000004146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic