Provider Demographics
NPI:1982130175
Name:SHEPPARD, ANDROS
Entity Type:Individual
Prefix:
First Name:ANDROS
Middle Name:
Last Name:SHEPPARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6919 SANDY KNOLLS DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-4822
Mailing Address - Country:US
Mailing Address - Phone:281-830-0511
Mailing Address - Fax:281-667-3116
Practice Address - Street 1:13512 HOMESTEAD RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77039-2726
Practice Address - Country:US
Practice Address - Phone:281-449-4382
Practice Address - Fax:281-667-3116
Is Sole Proprietor?:No
Enumeration Date:2017-05-07
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver