Individual
DR. ANDREW L. MASICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3500 GASTON AVE, 4 ROBERTS, DALLAS, TX 75246-2017
(214) 820-3000
(214) 820-3022
Mailing address
3500 GASTON AVE, 4 ROBERTS, DALLAS, TX 75246-2017
(214) 820-3000
(214) 820-3022
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M4327
TX
208M00000X
Hospitalist Physician
M4327
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187178201
—
TX
05
—
187178202
—
TX
01
—
8A0789
BCBS
TX
01
—
8CZ871
BCBSTX
TX
01
—
P01291021
PALMETTO/TRICARE
—
Enumeration date
07/05/2006
Last updated
06/11/2014
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