MEDICARE: MA ANDREA LANA ADVINCULA PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1407734	TX

General Provider Information

NPI Number	:	1073463311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MA ANDREA LANA ADVINCULA PT, DPT

Provider Business Mailing Address
First Line	:	3806 GREEN FIELDS DR
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-1957
Country	:	US
Telephone Number	:	832-245-5595
Fax Number	:	832-245-5595

Provider Business Practice Location Address
First Line	:	3806 GREEN FIELDS DR
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-1957
Country	:	US
Telephone Number	:	832-245-5595
Fax Number	:	832-245-5595

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2026
Last Update Date	:	01/28/2026

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