Provider Demographics
NPI:1629009360
Name:SCHERTZ PRIMARY CARE
Entity Type:Organization
Organization Name:SCHERTZ PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-945-2121
Mailing Address - Street 1:3401 ROY RICHARD DR
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-2711
Mailing Address - Country:US
Mailing Address - Phone:210-945-2121
Mailing Address - Fax:210-945-2221
Practice Address - Street 1:3401 ROY RICHARD DR
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-2711
Practice Address - Country:US
Practice Address - Phone:210-945-2121
Practice Address - Fax:210-945-2221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00128VMedicare ID - Type UnspecifiedGROUP MEDICARE NUMBER