Provider Demographics
NPI:1336986405
Name:CABALLERO, ALEXANDRA DAMIANA (NP)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:DAMIANA
Last Name:CABALLERO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7411 NICK ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-6783
Mailing Address - Country:US
Mailing Address - Phone:806-674-1642
Mailing Address - Fax:
Practice Address - Street 1:1307 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:FRIONA
Practice Address - State:TX
Practice Address - Zip Code:79035-1121
Practice Address - Country:US
Practice Address - Phone:806-250-2781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1168480363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner