Provider Demographics
NPI:1760575773
Name:ANDREWS, SANDY (PHD)
Entity Type:Individual
Prefix:
First Name:SANDY
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1823 FORTVIEW RD STE 106
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7663
Mailing Address - Country:US
Mailing Address - Phone:512-444-6110
Mailing Address - Fax:512-444-6124
Practice Address - Street 1:1823 FORTVIEW RD STE 106
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7663
Practice Address - Country:US
Practice Address - Phone:512-444-6110
Practice Address - Fax:512-444-6124
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24584103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX030055001Medicaid
TX00321EMedicare ID - Type Unspecified