Healthcare Provider Details

I. General information

NPI: 1538284286
Provider Name (Legal Business Name): ANDREW F BROOKER JR. M.D. PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ANDREW F BROOKER JR. M.D.,PA

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S COULTER ST BLDG F
AMARILLO TX
79106-1710
US

IV. Provider business mailing address

PO BOX 844798
DALLAS TX
75284-4798
US

V. Phone/Fax

Practice location:
  • Phone: 806-398-3627
  • Fax: 806-351-7801
Mailing address:
  • Phone: 806-398-3627
  • Fax: 806-351-7801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberJ5961
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: