Provider Demographics
NPI:1396332284
Name:DIALS, ANDREW EDWARD (LPA, MA)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:EDWARD
Last Name:DIALS
Suffix:
Gender:M
Credentials:LPA, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 QUINCE AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-2445
Mailing Address - Country:US
Mailing Address - Phone:956-800-5679
Mailing Address - Fax:
Practice Address - Street 1:807 QUINCE AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2445
Practice Address - Country:US
Practice Address - Phone:956-800-5679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-24
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38718261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health