Provider Demographics
NPI:1629158134
Name:ROCKWOOD, ANDREW P (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:P
Last Name:ROCKWOOD
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 1:213 E SAN ANTONIO ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-4137
Mailing Address - Country:US
Mailing Address - Phone:830-997-0813
Mailing Address - Fax:830-997-6443
Practice Address - Street 1:213 E SAN ANTONIO ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-4137
Practice Address - Country:US
Practice Address - Phone:830-997-0813
Practice Address - Fax:830-997-6443
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1407208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1206146-04Medicaid
00G99NMedicare ID - Type Unspecified
C21183Medicare UPIN