MEDICARE: DR. TRIAUNDRA ANDREWS D.C.

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
1	111N00000X	Chiropractor	13053	TX
2	111NN0400X	Neurology Chiropractor	13053	TX

General Provider Information

NPI Number	:	1295106896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRIAUNDRA ANDREWS D.C.

Provider Business Mailing Address
First Line	:	18321 W LAKE HOUSTON PKWY
Second Line	:	SUITE 310
City	:	HUMBLE
State	:	TX
Zip	:	77346-3587
Country	:	US
Telephone Number	:	281-812-0306
Fax Number	:

Provider Business Practice Location Address
First Line	:	18321 W LAKE HOUSTON PKWY
Second Line	:	SUITE 310
City	:	HUMBLE
State	:	TX
Zip	:	77346-3587
Country	:	US
Telephone Number	:	281-812-0306
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2015
Last Update Date	:	04/13/2016

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