Gregory Aaron Andis, M.S., LAT, ATC, PTA
Individual provider Active NPI Physical Therapy Assistant · Odessa, TX
NPI 1629112693 · NPPES record last updated Mar 22, 2013
Key facts
- NPI
- 1629112693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2089219 (TX)
- Practice address
- 2525 N Grandview Ave
Suite 400
Odessa, TX 79761-1600 - Phone
- (432) 550-4700
- Fax
- (432) 550-4715
- NPI assigned
- Feb 16, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2089219 | TX | MD | Physical Therapy Assistant |
| AT 1622 | TX | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT 1622 | TX | |
| Physical Therapy Assistant | 225200000X | 2089219 | TX | Yes |
Addresses
Primary practice location
2525 N Grandview Ave
Suite 400
Odessa, TX 79761-1600
Mailing address
47 Hawaii CV
Odessa, TX 79762-4909
Phone (432) 553-3131
Other providers in Odessa, TX
- Brooke Hannah Anderson
- Charlotte Anderson
- Errol Claude Anderson
- Wesley Dale Anderson
- Andes Dental PLLC
- Grace Castillo Andrade
- Liliana Coromoto Andrade
- Obianuju Mercy Anelo
- Dimitrios Angelis
- Manohar Angirekula
All providers in Odessa, TX · Physical Therapy Assistant in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.