Provider Demographics
NPI:1528033396
Name:ANDREWS, SUSANNAH S (PA-C)
Entity Type:Individual
Prefix:
First Name:SUSANNAH
Middle Name:S
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3786 FM 1488 RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4989
Mailing Address - Country:US
Mailing Address - Phone:281-364-8844
Mailing Address - Fax:281-364-8833
Practice Address - Street 1:13325 HARGRAVE RD STE 130&140
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4539
Practice Address - Country:US
Practice Address - Phone:713-345-1220
Practice Address - Fax:713-345-1228
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03179363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ19882Medicare UPIN
TX8C1075Medicare PIN