Provider Demographics
NPI:1992723597
Name:ALEXANDER, SAJI
Entity type:Individual
Prefix:
First Name:SAJI
Middle Name:
Last Name:ALEXANDER
Suffix:
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:PO BOX 38111
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77238-8111
Mailing Address - Country:US
Mailing Address - Phone:713-692-1133
Mailing Address - Fax:713-692-2299
Practice Address - Street 1:411 W PARKER RD
Practice Address - Street 2:SUITE A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77091-3202
Practice Address - Country:US
Practice Address - Phone:713-692-1133
Practice Address - Fax:713-692-2299
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18454247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7118221OtherAETNA
TX1582165-01Medicaid
TX0036DCOtherBC/BS
TXFTA117Medicare ID - Type Unspecified