Healthcare Provider Details

I. General information

NPI: 1366184103
Provider Name (Legal Business Name): ANDRIELLE COLLIER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2022
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5680 FRISCO SQUARE BLVD STE 1200
FRISCO TX
75034-3323
US

IV. Provider business mailing address

PO BOX 733784
DALLAS TX
75373-3784
US

V. Phone/Fax

Practice location:
  • Phone: 972-403-5437
  • Fax: 972-403-5438
Mailing address:
  • Phone: 682-885-6483
  • Fax: 682-885-3113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberV8604
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: