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NPI Code Detail

MEDICARE: ANDREA LYNN MCCOY NP

MEDICARE: ANDREA LYNN MCCOY NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner71013660AIN
2363LG0600XGerontology Nurse Practitioner209025961IL
3363LA2200XAdult Health Nurse Practitioner28225654AIN
4363LG0600XGerontology Nurse Practitioner71013660AIN

General Provider Information

NPI Number : 1053032482
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA LYNN MCCOY NP
Provider Business Mailing Address
First Line : 440 LOUISIANA ST STE 900
Second Line :
City : HOUSTON
State : TX
Zip : 77002-1062
Country : US
Telephone Number : 914-432-2166
Fax Number : 800-886-7167
Provider Business Practice Location Address
First Line : 440 LOUISIANA ST STE 900
Second Line :
City : HOUSTON
State : TX
Zip : 77002-1062
Country : US
Telephone Number : 914-432-2166
Fax Number : 800-886-7167
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2022
Last Update Date : 06/15/2026

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