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General NPI Number Information
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NPI Number | 1932807922
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Entity Type | Individual
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Provider Name | ANDREW CONTRERAS
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Gender | Male
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 5323 HARRY HINES BLVD
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City | DALLAS
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State | TX
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Zip | 75390-5983
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Country | US
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Telephone | 214-648-3433
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Fax |
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Provider Business Mailing Address
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Address Line | 3086 REN WAY
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City | MADERA
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State | CA
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Zip | 93637-5983
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Country | US
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Telephone | 559-514-4064
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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