Healthcare Provider Details

I. General information

NPI: 1013436062
Provider Name (Legal Business Name): ANDREW J BRELAND MS, MPAS, LPC, PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2017
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 N TEXAS AVE STE 2200
WEBSTER TX
77598-4964
US

IV. Provider business mailing address

333 N TEXAS AVE STE 2200
WEBSTER TX
77598-4964
US

V. Phone/Fax

Practice location:
  • Phone: 832-404-2601
  • Fax: 832-404-2601
Mailing address:
  • Phone: 832-404-2601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number13744
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2281
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number75012
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA19080
License Number StateTX
# 5
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA19080
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: