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General NPI Number Information
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NPI Number | 1447473046
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Entity Type | Individual
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Provider Name | ANDREA P FORD DO
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Gender | Female
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 10/29/2020
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Provider Practice Location Address
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Address Line | 2005 FORT WORTH HWY STE 100
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City | WEATHERFORD
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State | TX
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Zip | 76086-4780
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Country | US
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Telephone | 817-598-5625
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Fax |
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Provider Business Mailing Address
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Address Line | 2005 FORT WORTH HWY STE 100
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City | WEATHERFORD
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State | TX
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Zip | 76086-4780
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Country | US
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Telephone | 817-598-5625
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2008-00212
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | S4285
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License Number State | TX
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