=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548617061
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANDREW W AWAD M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/16/2016
-----------------------------------------------------
Last Update Date | 07/22/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6100 COLLEYVILLE BLVD STE 160
-----------------------------------------------------
City | COLLEYVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76034-8021
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-587-9074
-----------------------------------------------------
Fax | 817-803-8768
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6100 COLLEYVILLE BLVD STE 160
-----------------------------------------------------
City | COLLEYVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76034-8021
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-587-9074
-----------------------------------------------------
Fax | 817-803-8768
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 300420
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | ME150167
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | S0619
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------