Provider Demographics
NPI:1215608765
Name:HIRAKAWA, ANDREW MINORU
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:MINORU
Last Name:HIRAKAWA
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 1:2929 N STEMMONS FWY XA 1.2
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-8522
Mailing Address - Country:US
Mailing Address - Phone:214-645-6828
Mailing Address - Fax:214-645-6829
Practice Address - Street 1:2929 N STEMMONS FWY XA 1.2
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-5422
Practice Address - Country:US
Practice Address - Phone:214-645-6828
Practice Address - Fax:214-645-6829
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69523183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist