Provider Demographics
NPI:1992935613
Name:CARUSO, ANDREW C (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:C
Last Name:CARUSO
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 1:3519 PICKERING LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7057
Mailing Address - Country:US
Mailing Address - Phone:817-504-3173
Mailing Address - Fax:
Practice Address - Street 1:3519 PICKERING LN
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7057
Practice Address - Country:US
Practice Address - Phone:817-504-3173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-15
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10034457207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine