Provider Demographics
NPI:1033506019
Name:SPLINTER, ALICE RENEE (MD)
Entity type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:RENEE
Last Name:SPLINTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:RENEE
Other - Last Name:HUBBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1610
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75751-9004
Mailing Address - Country:US
Mailing Address - Phone:903-887-1011
Mailing Address - Fax:903-603-9441
Practice Address - Street 1:801 W. MAIN ST.
Practice Address - Street 2:
Practice Address - City:GUN BARREL CITY
Practice Address - State:TX
Practice Address - Zip Code:75156-5312
Practice Address - Country:US
Practice Address - Phone:903-887-1011
Practice Address - Fax:903-603-9441
Is Sole Proprietor?:No
Enumeration Date:2015-04-17
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR6109208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX387130301Medicaid