Provider Demographics
NPI:1902284805
Name:ELKO, ALEXANDRA RAE (DO)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:RAE
Last Name:ELKO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3500 W WHEATLAND RD
Mailing Address - Street 2:METHODIST CHARLTON MEDICAL CENTER FAMILY MEDICINE
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-3460
Mailing Address - Country:US
Mailing Address - Phone:214-947-5400
Mailing Address - Fax:214-947-5476
Practice Address - Street 1:3500 W WHEATLAND RD
Practice Address - Street 2:METHODIST CHARLTON MEDICAL CENTER FAMILY MEDICINE
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3460
Practice Address - Country:US
Practice Address - Phone:214-947-5400
Practice Address - Fax:214-947-5476
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-12
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10054193207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine