Provider Demographics
NPI:1033265137
Name:SPAFFORD, ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:SPAFFORD
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 1:6401 CYPRESSWOOD DR
Mailing Address - Street 2:SUITE 180
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-8199
Mailing Address - Country:US
Mailing Address - Phone:281-866-7080
Mailing Address - Fax:281-866-7151
Practice Address - Street 1:6401 CYPRESSWOOD DR
Practice Address - Street 2:SUITE 180
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-8199
Practice Address - Country:US
Practice Address - Phone:281-866-7080
Practice Address - Fax:281-866-7151
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4804207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092394801Medicaid
8P9170Medicare UPIN
TX8F0277Medicare ID - Type Unspecified