Andrew Thomas Brockway
Specialist/Technologist, Athletic Trainer in Allen, TX. Individual provider (NPI-1).
NPI number1366076796
StatusActive
Last updated in NPPESFeb 25, 2020
Details
- NPI
- 1366076796
- Entity type
- Individual (NPI-1)
- Name
- Andrew Thomas Brockway
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 25, 2020
- Certification date
- Feb 25, 2020
- Last updated
- Feb 25, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | AT4033 | TX | Yes |
Practice location
1120 Raintree Cir Ste 280Allen, TX 75013-5258
Phone 214-383-9356 · Fax 214-383-9886
Mailing address
1120 Raintree Cir Ste 280Allen, TX 75013-5258
Phone 214-383-9356 · Fax 214-383-9886
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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