Provider Demographics
NPI:1558326157
Name:DARNELL, ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:DARNELL
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 1:5704 TAHOMA PLACE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759
Mailing Address - Country:US
Mailing Address - Phone:512-331-7512
Mailing Address - Fax:
Practice Address - Street 1:16030 PARK VALLEY DR
Practice Address - Street 2:STE 100
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-3647
Practice Address - Country:US
Practice Address - Phone:512-246-8777
Practice Address - Fax:512-246-8776
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE5045207L00000X
CAG30464207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX097643301Medicaid
TXHH1391OtherBLUE CROSS INSURANCE
TXP081H391ZMedicaid
TX097643301Medicaid
TXP081H391ZMedicaid