Provider Demographics
NPI:1285497669
Name:ALPHA T MEN'S HEALTH
Entity type:Organization
Organization Name:ALPHA T MEN'S HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:DR
Authorized Official - First Name:BARACK
Authorized Official - Middle Name:AUSTINE
Authorized Official - Last Name:OTIENO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN , FNP, BC
Authorized Official - Phone:682-899-5028
Mailing Address - Street 1:1108 W PIONEER PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-7627
Mailing Address - Country:US
Mailing Address - Phone:682-899-5028
Mailing Address - Fax:682-252-4072
Practice Address - Street 1:1108 W PIONEER PKWY STE 100
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-7627
Practice Address - Country:US
Practice Address - Phone:682-899-5028
Practice Address - Fax:682-252-4072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty