Provider Demographics
NPI:1821239344
Name:ANDREWS, DAINEL CULLEN SR (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:DAINEL
Middle Name:CULLEN
Last Name:ANDREWS
Suffix:SR
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 WAHOO DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-8528
Mailing Address - Country:US
Mailing Address - Phone:682-225-3673
Mailing Address - Fax:
Practice Address - Street 1:1501 HARLIN DR
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-7039
Practice Address - Country:US
Practice Address - Phone:817-202-1692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT33392255A2300X
0508020452255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer