MEDICARE: ANDREA HULL 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	1248516	TX

General Provider Information

NPI Number	:	1942601026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA HULL DPT

Provider Business Mailing Address
First Line	:	3404 S PADRE ISLAND DR.
Second Line	:	STE. 301
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78415
Country	:	US
Telephone Number	:	361-445-3969
Fax Number	:

Provider Business Practice Location Address
First Line	:	3403 S PADRE ISLAND DR
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78415-2924
Country	:	US
Telephone Number	:	361-445-3969
Fax Number	:

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

Provider Enumeration Date	:	09/09/2014
Last Update Date	:	09/09/2014

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