Basic Information
| Provider Information | |||||||||
| NPI: | 1205868031 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANDREW W HOOVER MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 S MAIN STREET | ||||||||
| Address2: | #100 | ||||||||
| City: | RHOME | ||||||||
| State: | TX | ||||||||
| PostalCode: | 76078 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8176362018 | ||||||||
| FaxNumber: | 8176362022 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 S MAIN ST | ||||||||
| Address2: | STE 100 | ||||||||
| City: | RHOME | ||||||||
| State: | TX | ||||||||
| PostalCode: | 76078 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8176362018 | ||||||||
| FaxNumber: | 8176362022 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2006 | ||||||||
| LastUpdateDate: | 01/06/2012 | ||||||||
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| AuthorizedOfficialLastName: | HOOVER | ||||||||
| AuthorizedOfficialFirstName: | ANDREW | ||||||||
| AuthorizedOfficialMiddleName: | W | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8176362018 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | J4214 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0004HW | 01 | TX | BCBS | OTHER | 80166950 | 01 | RR MCARE | OTHER |