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Individual

ALEKSANDRA VIDACIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
120 E HARRIS AVE, SAN ANGELO, TX 76903-5904
(325) 653-6741
(325) 481-2166
Mailing address
PO BOX 22000, SAN ANGELO, TX 76902-7200
(325) 658-1511
(325) 481-2166

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP10026411
TX
207R00000X
Internal Medicine Physician
Primary
N4181
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
206611002
TX
05
206611003
TX
05
206611006
TX
05
206611007
TX
01
3864783243
MYUTMB 3864783243-COMMERCIAL NUMBER
Enumeration date
06/14/2007
Last updated
12/02/2014
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