Provider Demographics
NPI:1265859425
Name:MCLELLAN, SCOTT ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ANDREW
Last Name:MCLELLAN
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 1:2600 LEXINGTON PL
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-4521
Mailing Address - Country:US
Mailing Address - Phone:469-537-5476
Mailing Address - Fax:
Practice Address - Street 1:4600 MUELLER BLVD
Practice Address - Street 2:APT 1009
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3186
Practice Address - Country:US
Practice Address - Phone:512-505-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12065111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor