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Individual

ANDREA A TATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC, LAT

Contact information

Practice address
42202 FM 1774, MAGNOLIA, TX 77353-4204
(281) 252-2550
(281) 252-2563
Mailing address
PO BOX 426, MAGNOLIA, TX 77353-0426
(281) 252-2550
(281) 252-2563

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT3293
TX

Other

Enumeration date
04/17/2009
Last updated
04/17/2009
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