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NPI Code Detail

MEDICARE: ANDREA MIDYETT PHD

MEDICARE: ANDREA MIDYETT PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist45802TX

General Provider Information

NPI Number : 1598360497
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA MIDYETT PHD
Provider Business Mailing Address
First Line : 7442 S STAPLES ST
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78413-5316
Country : US
Telephone Number : 361-991-0289
Fax Number :
Provider Business Practice Location Address
First Line : 7442 S STAPLES ST
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78413-5316
Country : US
Telephone Number : 361-991-0289
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2020
Last Update Date : 12/01/2020

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Directions to “ ANDREA MIDYETT PHD” Practice Location

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