Individual
DR. ALEXANDRA MARIE SAMUELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
670 S COMMERCIAL ST, HARRISONVILLE, MO 64701-1653
(816) 478-1230
Mailing address
4801 S CLIFF AVE STE 100, INDEPENDENCE, MO 64055-6954
(816) 478-1230
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2021020008
MO
152W00000X
Optometrist
9221T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q00126189
RAILROAD MEDICARE
MO
Enumeration date
06/19/2017
Last updated
09/21/2021
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