Andrew L Dejong
Pediatric Otolaryngology Plastic Surgeon (Head & Neck)
1730 Birmingham Dr
College Station
, Texas 77845-4063
Andrew L Dejong
Pediatric Otolaryngology Plastic Surgeon (Head & Neck)
1730 Birmingham Dr
College Station
, Texas 77845-4063
(979) 693-1900
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About
Features
Specialties
- Pediatric Otolaryngology
- Plastic Surgeon (Head & Neck)
Languages spoken
- English
Location
First Address
- Andrew L Dejong
- Po Box 10194
- College Station, TX
- Zip : 77842-0194
- Fax : (979) 693-1900
- Phone : (979) 693-6000
Second Address
- Andrew L Dejong
- 1730 Birmingham Dr
- College Station, TX
- Zip : 77845-4063
- Fax : (979) 693-1900
- Phone : (979) 693-6000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207YP0228X | Pediatric Otolaryngology | J1079 | TX |
| N | 207YX0007X | Plastic Surgeon (Head & Neck) | J1079 | TX |
National Provider Identifier
| NPI | 1750328092 |
|---|---|
| Provider Name | Andrew L Dejong |
| First Address | College Station, TX 77842-0194 |
| Second Address | College Station, TX 77845-4063 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/06/2006 |
| Last Update Date | 16/09/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 135825109 | (05) | TX |
| 80102845 | DPS (01) | TX |
| BD5385542 | DEA (01) | TX |
| G48167 | (02) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.