Provider Demographics
NPI:1275509168
Name:GIANNOTTI, ANDREW G (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:G
Last Name:GIANNOTTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:20333 STATE HIGHWAY 249 STE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-2613
Mailing Address - Country:US
Mailing Address - Phone:713-909-0179
Mailing Address - Fax:713-714-5842
Practice Address - Street 1:20333 STATE HIGHWAY 249 STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-2613
Practice Address - Country:US
Practice Address - Phone:713-909-0179
Practice Address - Fax:713-714-5842
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM79912083A0300X, 207LA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction Medicine
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8311433Medicaid
OR286900Medicaid
TX8CD191OtherBLUE CROSS BLUE SHIELD
OR050088489OtherRR MEDICARE
TXP00797255OtherMEDICARE RAILROAD
H60851Medicare UPIN
TXP00797255OtherMEDICARE RAILROAD
TX8CD191OtherBLUE CROSS BLUE SHIELD