Provider Demographics
NPI:1477644649
Name:WEST, ANDREW J (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:WEST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4330 MEDICAL DR STE 500
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3318
Mailing Address - Country:US
Mailing Address - Phone:210-558-0122
Mailing Address - Fax:210-558-0120
Practice Address - Street 1:4330 MEDICAL DR STE 500
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3318
Practice Address - Country:US
Practice Address - Phone:210-558-0122
Practice Address - Fax:210-558-0120
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI153001207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B4620OtherBCBS
TX143880601Medicaid
TXTXB132246OtherWELLMED NETWORKS INC
TX060065114Medicare PIN
TX8089N0Medicare PIN
TXF92934Medicare UPIN