Organization Active NPI

Thomas Howard Alexander Jr

  • Physiological Laboratory
  • Tyler, TX
National Provider Identifier
1184953580
Registry record updated May 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
THOMAS HOWARD ALEXANDER JR
Practice address
700 Olympic Plaza Cir Ste 906B
Tyler, TX 75701-1958
Phone
(903) 592-8685
NPI assigned
Dec 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Thomas Howard Alexander Jr., R.V.T.
Title
Owner
Phone
(903) 592-8685

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X Primary

Addresses

Primary practice location

700 Olympic Plaza Cir Ste 906B
Tyler, TX 75701-1958

Mailing address

PO Box 6813
Tyler, TX 75711-6813
Phone (903) 592-8685

Other identifiers 2

IdentifierTypeStateIssuer
P00953757OtherTXRR MEDICARE
088029602MedicaidTX

Other names 1

  • Thomas H Alexander Jr Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101115000547 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 5193910248 Practice locations: Tyler, TX

National Provider Directory

National Provider Directory

Locations

700 Olympic Plaza Cir
Ste 906B
Tyler, TX 75701
Phone (903) 592-8685

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1260748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337040000000",
    "number": "1184953580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6813",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757116813",
            "telephone_number": "903-592-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR STE 906B",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011958",
            "telephone_number": "903-592-8685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS HOWARD ALEXANDER JR",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-14",
        "last_updated": "2012-05-15",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-592-8685",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "R.V.T."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00953757",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "088029602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thomas H Alexander Jr Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.