MEDICARE: DR. ANDREW CHUBICK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	F0937	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CP7207	OTHER	TX	MEDICARE RAILROAD

General Provider Information

NPI Number	:	1003848607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW CHUBICK M.D.

Provider Business Mailing Address
First Line	:	712 N WASHINGTON AVE
Second Line	:	SUITE 300
City	:	DALLAS
State	:	TX
Zip	:	75246-1619
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	712 N WASHINGTON AVE
Second Line	:	SUITE 300
City	:	DALLAS
State	:	TX
Zip	:	75246-1619
Country	:	US
Telephone Number	:	214-823-6503
Fax Number	:	214-826-0605

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	01/02/2008

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Directions to “ DR. ANDREW CHUBICK M.D.” Practice Location

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