Provider Demographics
NPI:1346355344
Name:SKARPETOWSKI, ANDRZEJ C (MD)
Entity Type:Individual
Prefix:
First Name:ANDRZEJ
Middle Name:C
Last Name:SKARPETOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10811 TOWN CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4585
Mailing Address - Country:US
Mailing Address - Phone:210-572-0911
Mailing Address - Fax:
Practice Address - Street 1:10811 TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4585
Practice Address - Country:US
Practice Address - Phone:210-572-0911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8063207P00000X, 207Q00000X
ARE-4209207P00000X
NMMD2008-0652207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR157329001Medicaid
AR157329001Medicaid
ARI28401Medicare UPIN