Individual
ANDY LESTON HAWTHORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7200 WYOMING SPGS, STE 500, ROUND ROCK, TX 78681-4303
(512) 244-0111
(512) 244-2479
Mailing address
7200 WYOMING SPGS, STE 500, ROUND ROCK, TX 78681-4303
(512) 244-0111
(512) 244-2479
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M2640
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
192955601
—
TX
01
—
8AK836
BCBS
TX
01
—
9608066
AETNA
TX
Enumeration date
04/06/2007
Last updated
10/11/2021
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