Provider Demographics
NPI:1811900723
Name:ANDREWS, WILLIAM PAUL (PHD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:PAUL
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6691
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75711-6691
Mailing Address - Country:US
Mailing Address - Phone:903-581-2085
Mailing Address - Fax:903-595-1645
Practice Address - Street 1:306 E HOUSTON ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-8218
Practice Address - Country:US
Practice Address - Phone:903-581-2085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25607103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122194701Medicaid
TX0037AJMedicare PIN
R36081Medicare UPIN