Healthcare Provider Details

I. General information

NPI: 1942304480
Provider Name (Legal Business Name): ANDREA MICHELLE LUISE D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12117 BEE CAVES RD STE 201
BEE CAVE TX
78738-5349
US

IV. Provider business mailing address

10305 THISTLE MOSS CV
AUSTIN TX
78739-1443
US

V. Phone/Fax

Practice location:
  • Phone: 512-402-1881
  • Fax: 512-402-1895
Mailing address:
  • Phone: 512-402-1881
  • Fax: 512-402-1895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number10245
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: