MEDICARE: RICHARD C. ANDREWS, D.O., P.A.

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	207Q00000X	Family Medicine Physician
2	363LF0000X	Family Nurse Practitioner
3	363A00000X	Physician Assistant
4	207R00000X	Internal Medicine Physician	F7388	TX

General Provider Information

NPI Number	:	1609809409
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD C. ANDREWS, D.O., P.A.

Provider Business Mailing Address
First Line	:	519 E I30
Second Line	:	PMB 618
City	:	ROCKWALL
State	:	TX
Zip	:	75087-5408
Country	:	US
Telephone Number	:	214-339-9359
Fax Number	:	214-339-7326

Provider Business Practice Location Address
First Line	:	4373 S HAMPTON RD.
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75232-1058
Country	:	US
Telephone Number	:	214-339-9359
Fax Number	:	214-339-7326

Authorized Official
Title or Position	:	PHYSICIAN/PRESIDENT
Name	:	RICHARD CHARLES ANDREWS
Credential	:	D.O.
Telephone Number	:	214-339-9359

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	06/21/2010

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