Provider Demographics
NPI:1477553055
Name:SHER, ANDREW M (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:M
Last Name:SHER
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 1:1120 AVENUE G
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-3541
Mailing Address - Country:US
Mailing Address - Phone:979-245-5721
Mailing Address - Fax:979-245-1482
Practice Address - Street 1:1120 AVENUE G
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-3541
Practice Address - Country:US
Practice Address - Phone:979-245-5721
Practice Address - Fax:979-245-1482
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4519208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122217601Medicaid
TX122217601Medicaid
TX00445MMedicare PIN