Provider Demographics
NPI:1821960196
Name:GIANNASCOLI, ALEXANDER JACOB (ABOC)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:JACOB
Last Name:GIANNASCOLI
Suffix:
Gender:M
Credentials:ABOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 E PALM VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-2580
Mailing Address - Country:US
Mailing Address - Phone:512-218-9287
Mailing Address - Fax:512-218-9358
Practice Address - Street 1:4700 E PALM VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-2580
Practice Address - Country:US
Practice Address - Phone:512-218-9287
Practice Address - Fax:512-218-9358
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX259983156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician