Provider Demographics
NPI:1760458053
Name:BEHL, ANDREW J (DO)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:BEHL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:9229 LBJ FWY
Mailing Address - Street 2:STE 250
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3405
Mailing Address - Country:US
Mailing Address - Phone:800-346-0747
Mailing Address - Fax:972-739-2638
Practice Address - Street 1:3100 N TENAYA WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0436
Practice Address - Country:US
Practice Address - Phone:972-915-3600
Practice Address - Fax:972-915-3636
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2010-07-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL36068972207P00000X, 208600000X
NV1265207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36068972Medicaid
NV100511876Medicaid
IL36068972Medicaid
C40460Medicare UPIN
NVV104933Medicare PIN