MEDICARE: DR. ANDREW TIMOTHY BUTCHER PH.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	103TC0700X	Clinical Psychologist	31581	TX

General Provider Information

NPI Number	:	1962418566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW TIMOTHY BUTCHER PH.D.

Provider Business Mailing Address
First Line	:	2211 NORFOLK ST
Second Line	:	SUITE 460
City	:	HOUSTON
State	:	TX
Zip	:	77098-4096
Country	:	US
Telephone Number	:	713-523-0058
Fax Number	:	713-523-1165

Provider Business Practice Location Address
First Line	:	2211 NORFOLK ST
Second Line	:	SUITE 460
City	:	HOUSTON
State	:	TX
Zip	:	77098-4096
Country	:	US
Telephone Number	:	713-523-0058
Fax Number	:	713-523-1165

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	07/08/2007

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