Provider Demographics
NPI:1053696021
Name:RULAND, ANDREA (PA-C)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:RULAND
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E. TAYLOR ST.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-2881
Mailing Address - Country:US
Mailing Address - Phone:903-957-1104
Mailing Address - Fax:
Practice Address - Street 1:600 E. TAYLOR ST.
Practice Address - Street 2:SUITE 201
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2881
Practice Address - Country:US
Practice Address - Phone:903-957-1104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant