Provider Demographics
NPI:1215105648
Name:BOSSEN, ANDREW DOUGLAS (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:DOUGLAS
Last Name:BOSSEN
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 1:1625 N HIGHWAY 75
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-2815
Mailing Address - Country:US
Mailing Address - Phone:903-892-3282
Mailing Address - Fax:
Practice Address - Street 1:1625 N HIGHWAY 75
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2815
Practice Address - Country:US
Practice Address - Phone:903-892-3282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8551207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology