Provider Demographics
NPI:1780933366
Name:JOHN H. ANDERSON, MD, P.A.
Entity type:Organization
Organization Name:JOHN H. ANDERSON, MD, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-625-1786
Mailing Address - Street 1:901 LOOP 337 # A
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-3556
Mailing Address - Country:US
Mailing Address - Phone:830-625-1786
Mailing Address - Fax:830-606-7546
Practice Address - Street 1:901 LOOP 337 # A
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3556
Practice Address - Country:US
Practice Address - Phone:830-625-1786
Practice Address - Fax:830-606-7546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1158207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty