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1629053491

NPI Code Detail

MEDICARE: DR. ROBERT P ANDELMAN M.D.

MEDICARE: DR. ROBERT P ANDELMAN M.D.

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
1	207P00000X	Emergency Medicine Physician	K3669	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	930115385	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	930080743	OTHER	TX	RAILROAD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	82340J	OTHER	TX	BCBS
7	930080784	OTHER	TX	RAILROAD
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	8B7002	OTHER	TX	BCBS
10	82360J	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1629053491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT P ANDELMAN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 201606
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75320-1606
Country	:	US
Telephone Number	:	972-758-3523
Fax Number	:

Provider Business Practice Location Address
First Line	:	3301 MATLOCK RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76015-2908
Country	:	US
Telephone Number	:	972-758-3523
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	09/22/2011

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Directions to “ DR. ROBERT P ANDELMAN M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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