Provider Demographics
NPI:1215366869
Name:ATANU, ANDREW
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:ATANU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20003 BALLINGER RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-4057
Mailing Address - Country:US
Mailing Address - Phone:281-610-2086
Mailing Address - Fax:866-781-0831
Practice Address - Street 1:20003 BALLINGER RIDGE CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-4057
Practice Address - Country:US
Practice Address - Phone:832-863-8582
Practice Address - Fax:866-781-0831
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX016386251E00000X
3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant