Healthcare Provider Details

I. General information

NPI: 1295754497
Provider Name (Legal Business Name): ANDREW SENCHAK D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8080 INDEPENDENCE PKWY STE 255
PLANO TX
75025-4032
US

IV. Provider business mailing address

8080 INDEPENDENCE PKWY STE 255
PLANO TX
75025-4032
US

V. Phone/Fax

Practice location:
  • Phone: 469-678-2211
  • Fax: 469-678-2253
Mailing address:
  • Phone: 469-678-2211
  • Fax: 469-678-2253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberQ8348
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: