Individual
CHARLES E ANDREWS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
950 W MAGNOLIA AVE, FORT WORTH, TX 76104
(817) 336-5060
(817) 336-1744
Mailing address
950 W MAGNOLIA AVE, FORT WORTH, TX 76104
(817) 336-5060
(817) 336-1744
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
F8393
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10014258
AMERIGROUP
—
05
—
118142201
—
TX
05
—
1636207
—
LA
01
—
390002998
MEDICARE RAILROAD
—
01
—
4036866
AETNA
—
01
—
834767
BLUE CROSS BLUE SHIELD
TX
Enumeration date
06/15/2006
Last updated
05/18/2011
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