Provider Demographics
NPI:1063435915
Name:HUME, ANDREW (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:HUME
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22000
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76902-7200
Mailing Address - Country:US
Mailing Address - Phone:325-658-1511
Mailing Address - Fax:325-481-2165
Practice Address - Street 1:102 N MAGDALEN ST
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-5400
Practice Address - Country:US
Practice Address - Phone:325-658-1511
Practice Address - Fax:325-481-2165
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1268208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115391802Medicaid
TX827040OtherAUSTIN BCBS PROVIDER NO
TX85007XOtherSAN ANGELO BCBS PROV NO
TX741796484OtherTAX ID NO
TX82Z040OtherMEDICARE AUSTIN ID NUMBER
TX85007XOtherBCBS SAN ANGELO ID NUMBER
TX82Z040OtherBCBS AUSTIN ID NUMBER
TX85007XOtherBCBS SAN ANGELO ID NUMBER
TX741796484OtherTAX ID NO