Provider Demographics
NPI:1588935217
Name:MCCLELLAN, ANDREW JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JOSEPH
Last Name:MCCLELLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 N CENTRAL EXPY STE 100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5078
Mailing Address - Country:US
Mailing Address - Phone:214-692-6941
Mailing Address - Fax:
Practice Address - Street 1:9600 N CENTRAL EXPY STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5078
Practice Address - Country:US
Practice Address - Phone:214-692-6941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-26
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR1988207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology