Provider Demographics
NPI:1215985361
Name:ANDERS, GREGG THOMAS (DO)
Entity type:Individual
Prefix:DR
First Name:GREGG
Middle Name:THOMAS
Last Name:ANDERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:111 STANFORD DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-2009
Mailing Address - Country:US
Mailing Address - Phone:210-824-0859
Mailing Address - Fax:
Practice Address - Street 1:CARDIOLOGY SERVICE, BROOKE ARMY MEDICAL CENTER
Practice Address - Street 2:3851 ROGER BROOKE DRIVE
Practice Address - City:FT. SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234
Practice Address - Country:US
Practice Address - Phone:210-916-3305
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7687207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease