Provider Demographics
NPI:1013436062
Name:BRELAND, ANDREW J (MS, MPAS, LPC, PA-C)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:BRELAND
Suffix:
Gender:
Credentials:MS, MPAS, LPC, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 N TEXAS AVE STE 2200
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4964
Mailing Address - Country:US
Mailing Address - Phone:832-404-2601
Mailing Address - Fax:
Practice Address - Street 1:333 N TEXAS AVE STE 2200
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4964
Practice Address - Country:US
Practice Address - Phone:832-404-2601
Practice Address - Fax:832-404-2601
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-11
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13744101YA0400X
MS2281101YP2500X
TX75012101YP2500X
TXPA19080363AS0400X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX374571302Medicaid