Provider Demographics
NPI:1053023168
Name:TIJERINA, ALEXANDRIA (RN)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:TIJERINA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2345 REAGAN ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-3225
Mailing Address - Country:US
Mailing Address - Phone:214-766-0642
Mailing Address - Fax:512-371-6034
Practice Address - Street 1:2345 REAGAN ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-3225
Practice Address - Country:US
Practice Address - Phone:214-999-1044
Practice Address - Fax:469-293-4663
Is Sole Proprietor?:No
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1036900163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse