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General NPI Number Information
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NPI Number | 1861488694
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Entity Type | Organization
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Legal Business Name | ANDREWS COUNTY
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 208 NW 2ND ST
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City | ANDREWS
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State | TX
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Zip | 79714-6308
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Country | US
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Telephone | 432-524-1434
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Fax | 432-524-1461
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Provider Business Mailing Address
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Address Line | 208 NW 2ND ST
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City | ANDREWS
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State | TX
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Zip | 79714-6308
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Country | US
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Telephone | 432-524-1434
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Fax | 432-524-1461
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | GORDON MATTIMOE
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Credential | DNP, APRN, FNP-C
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Telephone | 432-524-1434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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