ANDREW L DEJONG (NPI# 1750328092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750328092 |
| Entity Type | Individual |
| Full Name | ANDREW L DEJONG |
| Credential | M.D. |
| Practice Address |
1730 Birmingham Dr College Station TX 77845-4063 |
| Mailing Address |
Po Box 10194 College Station TX 77842-0194 |
| Practice Telephone | 9796936000 |
| Practice Fax Number | 9796931900 |
| Mailing Telephone | 9796936000 |
| Mailing Fax Number | 9796931900 |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2011-09-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YP0228X |
Otolaryngology Specialization: Pediatric Otolaryngology |
J1079 | TX | Allopathic & Osteopathic Physicians |
| N | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
J1079 | TX | Allopathic & Osteopathic Physicians |
| N | 207YX0602X |
Otolaryngology Specialization: Otolaryngic Allergy |
J1079 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | DPS | 80102845 | 01 |
| TX | 135825109 | 05 | |
| TX | DEA | BD5385542 | 01 |
| Street Address |
1730 BIRMINGHAM DR |
| City | COLLEGE STATION |
| State | TX |
| Zip Code | 77845-4063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285632679 | Kellous Andrew Price | Otolaryngology | 1730 Birmingham Dr, College Station, TX 77845-4063 | 2005-07-11 |
| 1750935490 | Samantha Ruth Hudson | Audiologist | 1730 Birmingham Dr, College Station, TX 77845-4063 | 2019-07-31 |
| 1871984831 | Kathryn L Sossen | Nurse Practitioner | 1730 Birmingham Dr, Suite 100, College Station, TX 77845-4063 | 2015-02-12 |
| 1710316567 | Genna Lechler | Nurse Practitioner | 1730 Birmingham Dr, College Station, TX 77845-4063 | 2013-11-02 |
| 1619083854 | Michael F Mcmahon | Otolaryngology | 1730 Birmingham Dr, College Station, TX 77845-4063 | 2006-08-21 |
| 1013959287 | Ronald B Kuppersmith | Otolaryngology | 1730 Birmingham Dr, College Station, TX 77845-4063 | 2006-06-12 |
| 1972540409 | Lorin V Catalena | Physician Assistant | 1730 Birmingham Dr, College Station, TX 77845-4063 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518503101 | Aggieland Urgent Care Pllc | Clinic/Center | 13055 Fm 2154 Rd, College Station, TX 77845 | 2019-11-19 |
| 1770053399 | Alyssa Nicole Sanchez | Licensed Vocational Nurse | 4030 Hwy 6 S 150, College Station, TX 77845 | 2018-11-27 |
| 1154805778 | Medical Care Innovation, P.C. | Clinic/Center | 200 Quality Circle, College Station, TX 77845 | 2018-09-19 |
| 1003302530 | Kaye Lynn Tseng | Registered Nurse | 4030 Hightway 6 South, College Station, TX 77845 | 2018-07-09 |
| 1083117907 | College Station Dentistry and Orthodontics Pllc | Dentist | 11671 Fm 2154, Suite 400, College Station, TX 77845 | 2018-03-16 |
| 1912409954 | H-e-b, Lp | Clinical Medical Laboratory | 11675 Fm 2154, College Station, TX 77845 | 2018-03-06 |
| 1871095745 | Gregory Nicholas Perry | Physical Therapist | 4091 Sh 6 South, Suite B, College Station, TX 77845 | 2018-03-06 |
| 1811435639 | Michael Patke | Student in an Organized Health Care Education/Training Program | 10613 Deer Run Dr., College Station, TX 77845 | 2017-02-01 |
| 1558810473 | Sara Beth Williamson | Nurse Practitioner | 4401 State Hwy 6 S, College Station, TX 77845 | 2016-10-04 |
| 1881067379 | Kieshia Lewis | Occupational Therapy Assistant | 2700 Earl Rudder Frwy Suite 1200, College Station, TX 77845 | 2015-11-05 |
| Find all providers in zip 77845 | ||||
| Taxonomy Code | 207YP0228X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Pediatric Otolaryngology |
| A pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired conditions involving the aerodigestive tract, nose and paranasal sinuses, the ear and other areas of the head and neck. The pediatric otolaryngologist has special skills in the diagnosis, treatment, and management of childhood disorders of voice, speech, language and hearing. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740815950 | Yusif Hajiyev | Otolaryngology | 6701 Fannin St Ste 640.2, Houston, TX 77030-2608 | 2020-03-08 |
| 1548554645 | Continua Health Care Inc. | Otolaryngology | 926 Brooklyn Ave, San Antonio, TX 78215-1637 | 2011-06-06 |
| 1558522615 | Morgan Taylor Fordham Jr. | Otolaryngology | 333 N. Santa Rosa, Ste Ll, San Antonio, TX 78207 | 2008-06-21 |
| 1982876058 | Matthew Seth Sitton | Otolaryngology | 6701 Fannin St Ste 540, Houston, TX 77030-2608 | 2008-03-29 |
| 1700088739 | Ronald Jason Vilela | Otolaryngology | 6701 Fannin St Ste 640, Houston, TX 77030-2610 | 2007-06-01 |
| 1205891553 | Alan Douglas Murray | Otolaryngology | 783 N Denton Tap Rd, Suite 200, Coppell, TX 75019-2169 | 2006-04-19 |
| 1942265285 | Paul Wade Bauer | Otolaryngology | 783 N. Denton Tap Rd, Ste 200, Coppell, TX 75019 | 2006-04-19 |
| 1306807268 | William D Clark | Otolaryngology | 333 N Santa Rosa Street, Goldsbury Center Lower Level, San Antonio, TX 78207-3108 | 2006-03-30 |
| 1043270630 | Amy Cornelia Brenski | Otolaryngology | 11445 Dallas Pkwy Ste 240, Frisco, TX 75033-4254 | 2006-03-27 |
| 1376532929 | James Hao-yuang Liu | Otolaryngology | 17450 St Lukes Way, 200, The Woodlands, TX 77384-8044 | 2005-10-17 |
| Find all providers with the same taxonomy | ||||
| City | COLLEGE STATION |
| Zip Code | 77845 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.