Provider Demographics
NPI:1336105774
Name:KRETSCHMER, ANDREW PATRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:PATRICK
Last Name:KRETSCHMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 SHELL PORT SQ
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2884
Mailing Address - Country:US
Mailing Address - Phone:281-794-4146
Mailing Address - Fax:
Practice Address - Street 1:827 MAGNOLIA BLVD
Practice Address - Street 2:SUITE #6
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77355-8602
Practice Address - Country:US
Practice Address - Phone:281-356-2900
Practice Address - Fax:281-356-5830
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8223207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00262WMedicare ID - Type UnspecifiedGROUP MEDICARE #
TXB24118Medicare UPIN
TX8B4377Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE #