Provider Demographics
NPI:1053451815
Name:CHESSER, ANDREA ELEANOR (PA-C)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:ELEANOR
Last Name:CHESSER
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 1:5009 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:SNYDER
Mailing Address - State:TX
Mailing Address - Zip Code:79549
Mailing Address - Country:US
Mailing Address - Phone:325-573-1300
Mailing Address - Fax:325-573-2134
Practice Address - Street 1:5009 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:SNYDER
Practice Address - State:TX
Practice Address - Zip Code:79549
Practice Address - Country:US
Practice Address - Phone:325-573-1300
Practice Address - Fax:325-573-2134
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03322363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B2514Medicare ID - Type Unspecified
TXP57522Medicare UPIN