Provider Demographics
NPI:1942304480
Name:LUISE-WILLIAMS, ANDREA MICHELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:MICHELLE
Last Name:LUISE-WILLIAMS
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 1:11614 ARGONNE FOREST TRL APT B
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-2226
Mailing Address - Country:US
Mailing Address - Phone:512-294-2210
Mailing Address - Fax:512-912-2757
Practice Address - Street 1:1213 RANCH ROAD 620 S
Practice Address - Street 2:SUITE #201-B
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-6340
Practice Address - Country:US
Practice Address - Phone:512-663-0988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10245111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor