| Doctor Name: | MARVIN A ANDRADE |
| NPI Number: | 1013175876 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | PA05379 |
| Business Practice Address: | 807 N Cage Blvd Pharr, TX - 785773117 |
| Business Phone Number: | 9562831889 |
| Business Fax Number: | 9562837014 |
| Mailing Address: | 807 N Cage Blvd, PHARR |
| State: | TX |
| Postal Code: | 785773117 |
| Phone Number: | 9562831889 |
| Fax Number: | 9562837014 |
| NPI Enumeration Date: | 05/29/2008 |
| NPI Last Update Date: | 04/28/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | PA05379 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |