Provider Demographics
NPI:1891189593
Name:OLIVER, ANDREW (PT)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:OLIVER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 W UNIVERSITY DR
Mailing Address - Street 2:SUITE 119
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-3392
Mailing Address - Country:US
Mailing Address - Phone:972-569-8860
Mailing Address - Fax:
Practice Address - Street 1:1705 W UNIVERSITY DR
Practice Address - Street 2:SUITE 119
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-3392
Practice Address - Country:US
Practice Address - Phone:972-569-8860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12567882251X0800X
MA203112251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic