Provider Demographics
NPI:1235173667
Name:ANDREWS, TIMOTHY R (CRNA)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:R
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 720188
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-0188
Mailing Address - Country:US
Mailing Address - Phone:956-664-9771
Mailing Address - Fax:956-664-9773
Practice Address - Street 1:3513 W ALBERTA RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8466
Practice Address - Country:US
Practice Address - Phone:956-664-9771
Practice Address - Fax:956-664-9773
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX656504207L00000X
TXAPI09103367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX002530603Medicaid
TX8C8889Medicare ID - Type Unspecified
TX002530603Medicaid