Provider Demographics
NPI:1255331286
Name:AZAB, ANDREW P (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:P
Last Name:AZAB
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3903 98TH ST # 100
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-4017
Mailing Address - Country:US
Mailing Address - Phone:806-785-7246
Mailing Address - Fax:806-785-7264
Practice Address - Street 1:3903 98TH ST # 100
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-4017
Practice Address - Country:US
Practice Address - Phone:806-785-7246
Practice Address - Fax:806-785-7264
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-01
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01040000762111N00000X
WV508111N00000X
MD1442PT111N00000X
TX6633111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001864001Medicaid
350036205OtherRAILROAD MEDICARE
350036205OtherRAILROAD MEDICARE
TXU35655Medicare UPIN