Provider Demographics
NPI:1316296031
Name:CHARTRAIN, ANDREW PAUL (DPT)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:PAUL
Last Name:CHARTRAIN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2327 HIGHLANDS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-2007
Mailing Address - Country:US
Mailing Address - Phone:972-839-3744
Mailing Address - Fax:
Practice Address - Street 1:638 UPTOWN BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-3538
Practice Address - Country:US
Practice Address - Phone:469-272-3129
Practice Address - Fax:469-272-3145
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1198649225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist