Provider Demographics
NPI:1083840227
Name:CEARNAL, ANDREW KYLE (HIS)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:KYLE
Last Name:CEARNAL
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 S AUSTIN AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-7805
Mailing Address - Country:US
Mailing Address - Phone:512-863-4691
Mailing Address - Fax:512-863-0335
Practice Address - Street 1:1915 S AUSTIN AVE STE 101
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-7805
Practice Address - Country:US
Practice Address - Phone:512-863-4691
Practice Address - Fax:512-863-0335
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50655237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist