Provider Demographics
NPI:1346886371
Name:GARREAN, ANDREW LEE
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:LEE
Last Name:GARREAN
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 1:4148 E 51ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-3609
Mailing Address - Country:US
Mailing Address - Phone:918-384-0980
Mailing Address - Fax:918-384-0981
Practice Address - Street 1:4148 E 51ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-3609
Practice Address - Country:US
Practice Address - Phone:918-384-0980
Practice Address - Fax:918-384-0981
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK37D772720808251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health