Provider Demographics
NPI:1043624539
Name:ANDRAS, SOPHIA (LAC)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:
Last Name:ANDRAS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5604 SOUTHWEST PKWY
Mailing Address - Street 2:APT 3531
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-6222
Mailing Address - Country:US
Mailing Address - Phone:512-771-1292
Mailing Address - Fax:
Practice Address - Street 1:1502 W 6TH ST STE A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-5134
Practice Address - Country:US
Practice Address - Phone:512-771-1292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01525171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist