Individual
ALEXA D PHILIPOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
801 MATLOCK RD, MANSFIELD, TX 76063-9174
(817) 347-8400
(817) 347-8495
Mailing address
PO BOX 99213, FORT WORTH, TX 76199-0213
(682) 885-1860
(682) 885-1396
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA12130
TX
Other
Enumeration date
08/14/2018
Last updated
10/31/2019
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