Provider Demographics
NPI:1609861517
Name:WEARY, ANDREW HARVEY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:HARVEY
Last Name:WEARY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 S COLORADO ST STE A-D
Mailing Address - Street 2:
Mailing Address - City:LOCKHART
Mailing Address - State:TX
Mailing Address - Zip Code:78644-2700
Mailing Address - Country:US
Mailing Address - Phone:512-376-9690
Mailing Address - Fax:512-398-3755
Practice Address - Street 1:300 S COLORADO ST STE A-D
Practice Address - Street 2:
Practice Address - City:LOCKHART
Practice Address - State:TX
Practice Address - Zip Code:78644
Practice Address - Country:US
Practice Address - Phone:512-376-9690
Practice Address - Fax:512-398-3755
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF3659207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B1371Medicare Oscar/Certification
TXB27441Medicare UPIN