Provider Demographics
NPI:1538284286
Name:BROOKER, ANDREW F JR (MD PA)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:F
Last Name:BROOKER
Suffix:JR
Gender:M
Credentials:MD PA
Other - Prefix:DR
Other - First Name:ANDREW
Other - Middle Name:F
Other - Last Name:BROOKER
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:MD,PA
Mailing Address - Street 1:PO BOX 844798
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4798
Mailing Address - Country:US
Mailing Address - Phone:806-398-3627
Mailing Address - Fax:806-351-7801
Practice Address - Street 1:1600 S COULTER ST
Practice Address - Street 2:BLDG F
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1710
Practice Address - Country:US
Practice Address - Phone:806-398-3627
Practice Address - Fax:806-351-7801
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5961207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1105108-05Medicaid
TX1105108-05Medicaid
NM37879341OtherNEW MEXICO MEDICAID
TX930119490OtherMEDICARE RAILROAD
TX109227104OtherFIRSTCARE
TX8047MOOtherBLUE CROSS BLUE SHIELD
TX8047MOMedicare ID - Type Unspecified