He moved to Oakland, California, in 1957, and began a long history of working with various San Francisco Bay area musicians.

A self-taught pianist, he played with Big Mama Thornton, Jimmy Witherspoon, Muddy Waters, Buddy Guy and Albert Collins.

Alexander recorded two albums, The Rattler (1972) and The Dirt on the Ground (1973), for Arhoolie Records,[2] containing the songs "The Hoodoo Man (The Voodoo Woman and the Witch Doctor)", "St. James Infirmary", "Blue Tumbleweed", "Sundown", "Sufferin' with the Lowdown Blues", "Strange Woman", "Cold Feelin", "Jimmy, Is That You?

Records, a small blues label, released his album Black Widow Spider in 1993, followed by the hit Baddass in 1995 and Anatomy of a Woman in 1998.

[6][7] On Martin Luther King Day in 2011, the NPR Radio program All Things Considered broadcast a segment about Marshall, Texas, as the birthplace of the boogie-woogie style of piano playing.