Individual provider Active NPI

Andrea Sequeira Roberts, DC

  • Chiropractor
  • Colleyville, TX
National Provider Identifier
1477786697
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11240 Issued in TX
Practice address
6100 Colleyville Blvd
Ste 150
Colleyville, TX 76034-8025
Phone
(682) 214-7671
Fax
(682) 503-2711
NPI assigned
Sep 4, 2009
Last updated
Nov 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11240 TX Primary

Addresses

Primary practice location

6100 Colleyville Blvd
Ste 150
Colleyville, TX 76034-8025

Mailing address

3412 Andover Dr
Bedford, TX 76021-2928
Phone (817) 307-5848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11240TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Urologic Surgery LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1252022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1477786697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3412 ANDOVER DR",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760212928",
            "telephone_number": "817-307-5848",
            "fax_number": "817-249-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 COLLEYVILLE BLVD",
            "address_2": "STE 150",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760348025",
            "telephone_number": "682-214-7671",
            "fax_number": "682-503-2711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ANDREA",
        "middle_name": "SEQUEIRA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-04",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colleyville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.