Provider Demographics
NPI:1164457024
Name:JEFFREYS, ANDREW RICHARD
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:RICHARD
Last Name:JEFFREYS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5309 W UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-7824
Mailing Address - Country:US
Mailing Address - Phone:972-562-1018
Mailing Address - Fax:972-562-1026
Practice Address - Street 1:5309 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-7824
Practice Address - Country:US
Practice Address - Phone:972-562-1018
Practice Address - Fax:972-562-1026
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX625069363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ06858Medicare UPIN
TX8J7960Medicare PIN