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General NPI Number Information
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NPI Number | 1770762551
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Entity Type | Organization
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Legal Business Name | GREGORY D. ANDREASSIAN M.D., P.A.
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 08/06/2010
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Provider Practice Location Address
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Address Line | 205 W WINDCREST ST SUITE 220
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City | FREDERICKSBURG
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State | TX
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Zip | 78624-4479
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Country | US
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Telephone | 830-997-6773
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Fax | 830-997-1961
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Provider Business Mailing Address
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Address Line | 205 W WINDCREST ST SUITE 220
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City | FREDERICKSBURG
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State | TX
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Zip | 78624-4479
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Country | US
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Telephone | 830-997-6773
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Fax | 830-997-1961
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Authorized Official
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Title or Position | MEDICAL PHYSICIAN
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Name | DR. GREGORY D. ANDREASSIAN
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Credential | M.D.
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Telephone | 830-997-6773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | H0136
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License Number State | TX
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