Individual
DR. CAROL ANN ANDRUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1016 N VIRGINIA ST, PORT LAVACA, TX 77979-3000
(361) 552-0325
(361) 552-5926
Mailing address
815 N VIRGINIA ST, PORT LAVACA, TX 77979-3025
(361) 552-0325
(361) 552-5926
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
K0057
TX
207Q00000X
Family Medicine Physician
Primary
TXK0057
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173721501
—
TX
01
—
30095257
DPS
TX
01
—
K0057
STATE BOARD OF MEDICINE
TX
Enumeration date
07/24/2006
Last updated
10/10/2016
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