Provider Demographics
NPI:1710980362
Name:JAMIESON, ANDREW O (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:O
Last Name:JAMIESON
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 1:5477 GLEN LAKES DR
Mailing Address - Street 2:STE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-0946
Mailing Address - Country:US
Mailing Address - Phone:214-750-7776
Mailing Address - Fax:
Practice Address - Street 1:5477 GLEN LAKES DR
Practice Address - Street 2:STE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0946
Practice Address - Country:US
Practice Address - Phone:214-750-7776
Practice Address - Fax:214-750-4621
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH4969207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E03411Medicare UPIN
TX80Y780Medicare PIN