Provider Demographics
NPI:1285698092
Name:GORDON, ALEXIA L (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXIA
Middle Name:L
Last Name:GORDON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1800 MAIN ST
Mailing Address - Street 2:#415
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-5202
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:803-730-5207
Practice Address - Street 1:207 S HOUSTON ST
Practice Address - Street 2:SUITE 400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75202-4790
Practice Address - Country:US
Practice Address - Phone:214-655-3200
Practice Address - Fax:214-655-3213
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC18945207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine