Individual provider Active NPI

Daria Ivanova Alexandrova, M.D.

  • Pediatrics Physician
  • Dallas, TX
National Provider Identifier
1699864363
Registry record updated Aug 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
K5767 Issued in TX
Practice address
2750 W. Northwest Hwy
Suite 170
Dallas, TX 75220-4783
Phone
(214) 654-0007
Fax
(214) 654-9272
NPI assigned
Oct 12, 2006
Last updated
Aug 3, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X K5767 TX Primary

Addresses

Primary practice location

2750 W. Northwest Hwy
Suite 170
Dallas, TX 75220-4783

Mailing address

2750 W. Northwest Hwy
Suite 170
Dallas, TX 75220-4783
Phone (214) 654-0007

Other identifiers 1

IdentifierTypeStateIssuer
043243702MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K5767TXMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312329600000",
    "number": "1699864363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 W. NORTHWEST HWY",
            "address_2": "SUITE 170",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752204783",
            "telephone_number": "214-654-0007",
            "fax_number": "214-654-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 W. NORTHWEST HWY",
            "address_2": "SUITE 170",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752204783",
            "telephone_number": "214-654-0007",
            "fax_number": "214-654-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDROVA",
        "first_name": "DARIA",
        "middle_name": "IVANOVA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K5767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043243702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.