Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | BP10068528 | TX |
N | 111NI0900X | Internist | BP10068528 | TX |
Y | 207W00000X | Ophthalmologist | BP20073416 | TX |
NPI | 1033776299 |
---|---|
Provider Name | Alexis Renee Pascoe |
First Address | Galveston, TX 77555-0570 |
Second Address | Galveston, TX 77555-5302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2019 |
Last Update Date | 23/06/2020 |