Provider Demographics
NPI:1063472991
Name:APPLEWHITE, ANDREW J (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:APPLEWHITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 225971
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75222-5971
Mailing Address - Country:US
Mailing Address - Phone:972-786-0140
Mailing Address - Fax:972-786-0142
Practice Address - Street 1:3500 GASTON AVE
Practice Address - Street 2:SUITE 210 BARNETT
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2017
Practice Address - Country:US
Practice Address - Phone:214-820-4400
Practice Address - Fax:214-820-4422
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5228207Q00000X, 2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CD558OtherBCBS
TX156332202Medicaid
TX204379250OtherTAX ID
TXP00645878OtherRAILROAD MEDICARE
TX156332202Medicaid