Provider Demographics
NPI:1740069566
Name:MCCLAIN, ANDRIA SHANTE
Entity type:Individual
Prefix:
First Name:ANDRIA
Middle Name:SHANTE
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17630 WAYFOREST DR APT 423
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-7035
Mailing Address - Country:US
Mailing Address - Phone:832-253-2650
Mailing Address - Fax:
Practice Address - Street 1:17630 WAYFOREST DR APT 423
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-7035
Practice Address - Country:US
Practice Address - Phone:832-253-2650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health