MEDICARE: DR. GREGORY D. ANDREASSIAN M.D.,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	208600000X	Surgery Physician	H0136	TX

General Provider Information

NPI Number	:	1619973120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY D. ANDREASSIAN M.D.,P.A.

Provider Business Mailing Address
First Line	:	205 W WINDCREST ST
Second Line	:	STE 130
City	:	FREDERICKSBURG
State	:	TX
Zip	:	78624-4478
Country	:	US
Telephone Number	:	830-997-6773
Fax Number	:	830-997-1961

Provider Business Practice Location Address
First Line	:	205 W WINDCREST ST STE 130
Second Line	:
City	:	FREDERICKSBURG
State	:	TX
Zip	:	78624-4478
Country	:	US
Telephone Number	:	830-997-6773
Fax Number	:	830-997-1961

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

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	07/21/2022

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