MEDICARE: ANDREANA SARA MIN

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	363LF0000X	Family Nurse Practitioner	228523	OK
2	363LF0000X	Family Nurse Practitioner	1140704	TX
3	363LF0000X	Family Nurse Practitioner	316960	AZ

General Provider Information

NPI Number	:	1114799434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREANA SARA MIN

Provider Business Mailing Address
First Line	:	16135 PRESTON RD STE 120
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75248-3582
Country	:	US
Telephone Number	:	469-248-5690
Fax Number	:	620-710-7661

Provider Business Practice Location Address
First Line	:	9901 VALLEY RANCH PKWY E
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-4730
Country	:	US
Telephone Number	:	972-417-1936
Fax Number	:

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

Provider Enumeration Date	:	10/30/2023
Last Update Date	:	04/28/2026

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Directions to “ ANDREANA SARA MIN ” Practice Location

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