Provider Demographics
NPI:1699046722
Name:ALLAIRE, ALEXIS
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:ALLAIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 ROSS ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-4421
Mailing Address - Country:US
Mailing Address - Phone:956-361-6000
Mailing Address - Fax:956-361-6060
Practice Address - Street 1:1145 ROSS ST
Practice Address - Street 2:SUITE E
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-4421
Practice Address - Country:US
Practice Address - Phone:956-361-6000
Practice Address - Fax:956-361-6060
Is Sole Proprietor?:No
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2032407225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2032407OtherSTATE LICENSE