Provider Demographics
NPI:1134371099
Name:MCDONALD, ANDREA MICHELLE (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:MICHELLE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ANDREA
Other - Middle Name:MICHELLE
Other - Last Name:HEIKKINEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:820 E CARTWRIGHT RD
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-6000
Mailing Address - Country:US
Mailing Address - Phone:972-285-3232
Mailing Address - Fax:972-285-5993
Practice Address - Street 1:820 E CARTWRIGHT RD
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-6000
Practice Address - Country:US
Practice Address - Phone:972-285-3232
Practice Address - Fax:972-285-5993
Is Sole Proprietor?:No
Enumeration Date:2008-10-22
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11010111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8DT747OtherBCBS
TX11010OtherSTATE LICENSE
TX8DT747OtherBCBS
TX11010OtherSTATE LICENSE