Provider Demographics
NPI:1801882410
Name:ANDREWS III, CHARLEY JULIUS III (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLEY
Middle Name:JULIUS
Last Name:ANDREWS III
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:556 W BEDFORD EULESS RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053-3924
Mailing Address - Country:US
Mailing Address - Phone:817-283-4688
Mailing Address - Fax:817-540-0736
Practice Address - Street 1:556 W BEDFORD EULESS RD
Practice Address - Street 2:SUITE C
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76053-3924
Practice Address - Country:US
Practice Address - Phone:817-283-4688
Practice Address - Fax:817-540-0736
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2013-09-05
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Provider Licenses
StateLicense IDTaxonomies
TXE9512207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4077259OtherAETNA
TX826183484Medicare ID - Type UnspecifiedRRMEDICARE
TX4077259OtherAETNA
TXC12872Medicare UPIN