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Individual

ANDREW BUCHANAN SMALL IV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3901 W 15TH STREET, PLANO, TX 75075
(972) 596-6800
Mailing address
1820 PRESTON PARK BLVD, STE 1825, PLANO, TX 75093-5215
(972) 867-7862
(972) 612-1623

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
L1203
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
168061302
TX
01
8B7904
COLLIN COUNTY PTAN
TX
Enumeration date
05/04/2006
Last updated
03/28/2018
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