Provider Demographics
NPI:1356434146
Name:MARTIN, ANDREW H (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:H
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9150 HUEBNER RD
Mailing Address - Street 2:SUITE #255
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1558
Mailing Address - Country:US
Mailing Address - Phone:210-877-0700
Mailing Address - Fax:210-641-1816
Practice Address - Street 1:9150 HUEBNER RD
Practice Address - Street 2:SUITE #255
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1558
Practice Address - Country:US
Practice Address - Phone:210-877-0700
Practice Address - Fax:210-641-1816
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM53542084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8U9625OtherBCBS
TX184750102Medicaid
8K1859Medicare PIN