Provider Demographics
NPI:1992186829
Name:PAPENDIECK, ANDREW DEAN (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:DEAN
Last Name:PAPENDIECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ANDREW
Other - Middle Name:
Other - Last Name:PAPENDIECK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:120 BARTON RANCH CIR
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-3750
Mailing Address - Country:US
Mailing Address - Phone:512-415-8405
Mailing Address - Fax:512-675-2090
Practice Address - Street 1:651 SUNDOWN LANE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78669
Practice Address - Country:US
Practice Address - Phone:512-677-9013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-16
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI68000-020207Q00000X
CODR.0061334207Q00000X
TXBP10054213207Q00000X
UT10992605-1205207Q00000X
WI68000-20207Q00000X
TXR3932207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100095277Medicaid
TX678385OtherMEDICARE