Provider Demographics
NPI:1003996380
Name:SAMBELL, ANDREW C (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:C
Last Name:SAMBELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W INTERSTATE 20 STE 1
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-5851
Mailing Address - Country:US
Mailing Address - Phone:817-784-8268
Mailing Address - Fax:817-417-1151
Practice Address - Street 1:801 W INTERSTATE 20 STE 1
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-5851
Practice Address - Country:US
Practice Address - Phone:817-784-8268
Practice Address - Fax:817-417-1151
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3378208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX030936103Medicaid
TX030936105Medicaid
TX030936107Medicaid
TX030936108Medicaid
TX030936106Medicaid
TX030936104Medicaid
TX030936108Medicaid
TX8J0597Medicare PIN
TX030936106Medicaid
TX030936105Medicaid