MEDICARE: ANDREW HEIDEBRECHT 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	1261812	TX

General Provider Information

NPI Number	:	1750751376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW HEIDEBRECHT DPT

Provider Business Mailing Address
First Line	:	5425 HIGHWAY 6 STE D900
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-4384
Country	:	US
Telephone Number	:	281-208-9200
Fax Number	:	281-208-9210

Provider Business Practice Location Address
First Line	:	5425 HIGHWAY 6 STE D900
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-4384
Country	:	US
Telephone Number	:	281-208-9200
Fax Number	:	281-208-9210

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

Provider Enumeration Date	:	09/26/2015
Last Update Date	:	05/24/2023

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