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General NPI Number Information
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NPI Number | 1255384061
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Entity Type | Individual
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Provider Name | ANDREA M MCNIEL P.A.
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Gender | Female
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 04/29/2019
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Provider Practice Location Address
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Address Line | 18955 N MEMORIAL DR STE 240
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City | HUMBLE
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State | TX
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Zip | 77338-4271
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Country | US
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Telephone | 936-441-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 25511 BUDDE RD STE 2502
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City | THE WOODLANDS
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State | TX
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Zip | 77380-2388
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Country | US
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Telephone | 936-441-1010
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Fax | 866-475-9062
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA04340
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License Number State | TX
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