Provider Demographics
NPI:1932177458
Name:BARRETT, ANDREA JEAN (MD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:JEAN
Last Name:BARRETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1195 GARNER FIELD RD BLDG B
Mailing Address - Street 2:SUITE 300
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801-4820
Mailing Address - Country:US
Mailing Address - Phone:830-278-3086
Mailing Address - Fax:830-278-8873
Practice Address - Street 1:1195 GARNER FIELD RD BLDG B
Practice Address - Street 2:SUITE 300
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801-4820
Practice Address - Country:US
Practice Address - Phone:830-278-3086
Practice Address - Fax:830-278-8873
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60871207X00000X
WAMD35665207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0146359OtherLABOR AND INDUSTIRES
WI60871-20OtherWI STATE LIC
193192400OtherUS DEPARTMENT OF LABOR
WA8449035Medicaid
P00375433OtherRAILROAD MEDICARE
ID80757600Medicaid
WA4304BAOtherLOCAL BLUE SHIELD PLAN
G71404Medicare UPIN
WA8449035Medicaid
WA8863152Medicare PIN