Provider Demographics
NPI:1477786697
Name:ROBERTS, ANDREA SEQUEIRA (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:SEQUEIRA
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3412 ANDOVER DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-2928
Mailing Address - Country:US
Mailing Address - Phone:817-307-5848
Mailing Address - Fax:817-249-7680
Practice Address - Street 1:6100 COLLEYVILLE BLVD
Practice Address - Street 2:STE 150
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-8025
Practice Address - Country:US
Practice Address - Phone:682-214-7671
Practice Address - Fax:682-503-2711
Is Sole Proprietor?:No
Enumeration Date:2009-09-04
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11240111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor