Provider Demographics
NPI:1649553975
Name:LA ANDRES, MD PLLC
Entity type:Organization
Organization Name:LA ANDRES, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:ANDRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-275-7800
Mailing Address - Street 1:PO BOX 15040
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85267-5040
Mailing Address - Country:US
Mailing Address - Phone:480-275-7800
Mailing Address - Fax:480-758-4587
Practice Address - Street 1:8595 E BELL RD STE 103
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1306
Practice Address - Country:US
Practice Address - Phone:480-275-7800
Practice Address - Fax:480-758-4587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-22
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ40126208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty