Provider Demographics
NPI:1215348404
Name:MATTHEWS, ALEXANDRA STEPHANIE (DO)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:STEPHANIE
Last Name:MATTHEWS
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 1:1139 E SONTERRA BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4352
Mailing Address - Country:US
Mailing Address - Phone:210-545-7171
Mailing Address - Fax:210-545-7176
Practice Address - Street 1:1139 E SONTERRA BLVD STE 500
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258
Practice Address - Country:US
Practice Address - Phone:210-545-7171
Practice Address - Fax:210-545-7176
Is Sole Proprietor?:No
Enumeration Date:2014-05-11
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ6528207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX354153402Medicaid