Healthcare Provider Details

I. General information

NPI: 1376507475
Provider Name (Legal Business Name): ANDREW GLENN MAHAFFEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 SCENIC DR SUITE 3326
GEORGETOWN TX
78626-7724
US

IV. Provider business mailing address

2423 WILLIAMS DR STE 107
GEORGETOWN TX
78628-3269
US

V. Phone/Fax

Practice location:
  • Phone: 512-863-6850
  • Fax: 512-688-5477
Mailing address:
  • Phone: 877-800-5722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG5326
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: