Provider Demographics
NPI:1861105447
Name:ALEXANDER, JEFFERY LAJAMES
Entity type:Individual
Prefix:
First Name:JEFFERY
Middle Name:LAJAMES
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 COYOTE CANYON CT
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-7092
Mailing Address - Country:US
Mailing Address - Phone:801-833-7685
Mailing Address - Fax:
Practice Address - Street 1:602 COYOTE CANYON CT
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-7092
Practice Address - Country:US
Practice Address - Phone:801-833-7685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-28
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5618227900000X
AZ227900000X
UT11323110-5701227900000X
CA44364227900000X
TXRCP02004858227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered