Provider Demographics
NPI:1750357372
Name:RANKIN, ANDREW D (ATC, LAT)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:D
Last Name:RANKIN
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 W PEARL ST
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-1888
Mailing Address - Country:US
Mailing Address - Phone:817-408-4645
Mailing Address - Fax:817-406-4680
Practice Address - Street 1:2000 W PEARL ST
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-1888
Practice Address - Country:US
Practice Address - Phone:817-408-4645
Practice Address - Fax:817-406-4680
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT14502255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer