Provider Demographics
NPI:1659333862
Name:POPEJOY, ANDREW B (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:B
Last Name:POPEJOY
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 1:322 CANTERBURY DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-3992
Mailing Address - Country:US
Mailing Address - Phone:254-848-2459
Mailing Address - Fax:
Practice Address - Street 1:322 CANTERBURY DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-3992
Practice Address - Country:US
Practice Address - Phone:254-848-2459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0530207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1713026-01OtherCSHCN
TX8R3602OtherBLUE SHIELD
TX1713026-01Medicaid
TXI25379Medicare UPIN
TX1713026-01OtherCSHCN