Individual
ALEXANDER CHRISTIAN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-S
Contact information
Practice address
2405 CLEAR CREEK RD, KILLEEN, TX 76549-5775
(254) 618-1888
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
4585
TN
363A00000X
Physician Assistant
Primary
PA15352
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2020
Last updated
03/02/2022
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