Provider Demographics
NPI:1922119478
Name:MAGEE, ANDREA (MPT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:MAGEE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:WAHLEITHNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1229 CALEDONIA CT
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-8515
Mailing Address - Country:US
Mailing Address - Phone:949-547-7247
Mailing Address - Fax:
Practice Address - Street 1:1229 CALEDONIA CT
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-8515
Practice Address - Country:US
Practice Address - Phone:949-547-7247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30301225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist