Provider Demographics
NPI:1710516497
Name:ADLER, ALISSA REDKO (MD)
Entity type:Individual
Prefix:
First Name:ALISSA
Middle Name:REDKO
Last Name:ADLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALISSA
Other - Middle Name:
Other - Last Name:REDKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1900 SAINT JAMES PL STE 600
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-4136
Mailing Address - Country:US
Mailing Address - Phone:713-850-0240
Mailing Address - Fax:
Practice Address - Street 1:1900 SAINT JAMES PL STE 600
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-4136
Practice Address - Country:US
Practice Address - Phone:713-850-0240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-05
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU9193207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology