Provider Demographics
NPI:1235936535
Name:ALEXANDER, KIMBERLY (AGNP-C)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2629 SAGEBRUSH DR
Mailing Address - Street 2:
Mailing Address - City:GLENN HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:75154-1876
Mailing Address - Country:US
Mailing Address - Phone:469-245-9450
Mailing Address - Fax:
Practice Address - Street 1:2629 SAGEBRUSH DR
Practice Address - Street 2:
Practice Address - City:GLENN HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:75154-1876
Practice Address - Country:US
Practice Address - Phone:469-245-9450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAG02250052208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice