Provider Demographics
NPI:1457589020
Name:FRIESENHAHN, ANDREA KAY (MSPT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:KAY
Last Name:FRIESENHAHN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:KAY
Other - Last Name:TRAMMELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1701 W BEN WHITE BLVD
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7667
Mailing Address - Country:US
Mailing Address - Phone:512-440-1441
Mailing Address - Fax:512-440-1448
Practice Address - Street 1:1701 W BEN WHITE BLVD
Practice Address - Street 2:SUITE 100B
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7667
Practice Address - Country:US
Practice Address - Phone:512-440-1441
Practice Address - Fax:512-440-1448
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1188733225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX454834Medicare Oscar/Certification