Provider Demographics
NPI:1801955729
Name:ULLMAN, ANDREW DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:DAVID
Last Name:ULLMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6230 N . BELTLINE RD,
Mailing Address - Street 2:SUITE 305
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063
Mailing Address - Country:US
Mailing Address - Phone:972-714-9800
Mailing Address - Fax:
Practice Address - Street 1:6230 N . BELTLINE RD,
Practice Address - Street 2:SUITE 305
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063
Practice Address - Country:US
Practice Address - Phone:972-714-9800
Practice Address - Fax:972-714-9883
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6613111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX609382Medicare PIN
TXU56579Medicare UPIN