Provider Demographics
NPI:1215532312
Name:ELGUEZABAL, ALEXANDER F JR
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:F
Last Name:ELGUEZABAL
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32815 TAMINA RD STE A
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-3394
Mailing Address - Country:US
Mailing Address - Phone:281-356-2827
Mailing Address - Fax:281-259-9098
Practice Address - Street 1:32815 TAMINA RD STE A
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-3394
Practice Address - Country:US
Practice Address - Phone:281-356-2827
Practice Address - Fax:281-259-9098
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion