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Andlyco, LLC

Organization Active NPI General Practice Physician · Deer Park, TX

NPI 1366824906 · NPPES record last updated Jun 19, 2015

Key facts

NPI
1366824906
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Physician 208D00000X
Legal business name
ANDLYCO, LLC
Practice address
1803 Center St
Suite a
Deer Park, TX 77536-3598
Phone
(713) 476-4600
Fax
(281) 930-8856
NPI assigned
Jun 19, 2015
Organization subpart
No

Authorized official

Name
Mrs. Karla R McClellan, CPA
Title
Cfo
Phone
(281) 680-4600

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2189399All American Screening & Medical
1803 Center St Suite a, Deer Park, TX 77536		Certificate of waiverJul 29, 2026

National Provider Directory

Tax ID family
All American Screening Medical (3 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 208D00000X Yes

Addresses

Primary practice location

1803 Center St
Suite a
Deer Park, TX 77536-3598

Mailing address

1803 Center St
Suite a
Deer Park, TX 77536-3598
Phone (713) 476-4600

Other names

  • All American Screening & Medical Doing business as

Other providers in Deer Park, TX

All providers in Deer Park, TX · General Practice Physician in Texas

Sources for this page

Verify at the official NPI Registry.