Provider Demographics
NPI:1669604534
Name:ANDRADE, JUANA MARIBEL (PA)
Entity type:Individual
Prefix:MS
First Name:JUANA
Middle Name:MARIBEL
Last Name:ANDRADE
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:8080 STATE HIGHWAY 121 STE 240
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2902
Mailing Address - Country:US
Mailing Address - Phone:972-268-9383
Mailing Address - Fax:972-870-4925
Practice Address - Street 1:8080 STATE HIGHWAY 121 STE 240
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070
Practice Address - Country:US
Practice Address - Phone:972-268-9383
Practice Address - Fax:972-870-4925
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2018-09-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA06229363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant