Provider Demographics
NPI:1326179672
Name:MEYER, ANDREW DJ, (MS, MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:DJ,
Last Name:MEYER
Suffix:
Gender:M
Credentials:MS, MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7703 FLOYD CURL DR
Mailing Address - Street 2:MC7977
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-450-9000
Mailing Address - Fax:
Practice Address - Street 1:4502 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4402
Practice Address - Country:US
Practice Address - Phone:210-358-1575
Practice Address - Fax:210-358-4775
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101240638207R00000X
VA0116016822208000000X
DCMD0373422080P0203X
TXP08552080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX285354101Medicaid
TX285354102OtherCSHCN
TX285354102OtherCSHCN