MEDICARE: DR. PAUL ANTHONY ANDRE O.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	152W00000X	Optometrist	10237T	CA

General Provider Information

NPI Number	:	1720067978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL ANTHONY ANDRE O.D.

Provider Business Mailing Address
First Line	:	762 HOLLY AVE
Second Line	:
City	:	LEMOORE
State	:	CA
Zip	:	93245-5202
Country	:	US
Telephone Number	:	998-559-2649
Fax Number	:	847-688-2289

Provider Business Practice Location Address
First Line	:	930 FRANKLIN BLVD
Second Line	:
City	:	LEMOORE
State	:	CA
Zip	:	93246-4600
Country	:	US
Telephone Number	:	998-559-2649
Fax Number	:

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

Provider Enumeration Date	:	01/14/2006
Last Update Date	:	02/07/2025

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