Provider Demographics
NPI:1568575140
Name:KOPEL, ANDREW CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:CHARLES
Last Name:KOPEL
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 1:2855 GRAMERCY ST # 400
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-1697
Mailing Address - Country:US
Mailing Address - Phone:713-668-6828
Mailing Address - Fax:
Practice Address - Street 1:2855 GRAMERCY ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-1756
Practice Address - Country:US
Practice Address - Phone:713-668-6828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3618207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX199504502Medicaid
TX8L3182Medicare PIN