Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0203X | Pediatric Critical Care Doctor | H9947 | TX |
Y | 2080P0214X | Pediatric Pulmonologist | H9947 | TX |
NPI | 1447235684 |
---|---|
Provider Name | Mr. Andrew Scott Gelfand |
First Address | Dallas, TX 75230-2540 |
Second Address | Dallas, TX 75230-2540 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2005 |
Last Update Date | 01/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10019430 | AMERIGROUP (01) | TX |
110672603 | (05) | TX |
8P8930 | BLUE CROSS BLUE SHIELD (01) | TX |
F69180 | (02) | TX |