Marvin A Andrade, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA05379 Issued in TX

Practice address

11811 Fallbrook Dr Ste B-2
Houston, TX 77065-3507

Phone

(832) 237-8882

Fax

(832) 237-8886

NPI assigned

May 29, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ambreen Aslam, M.D., PLLC

  • Pediatrics Physician
  • Houston, TX
  • NPI 1659523140
  NPD (past)
• St Marie Clinic P a

  • Family Medicine Physician
  • Mission, TX
  • NPI 1396764577
  NPD (past)
• Topcare Medical Group Inc

  • Specialist
  • Dallas, TX
  • NPI 1730337163
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1013175876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11811 FALLBROOK DR STE B-2",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770653507",
            "telephone_number": "832-237-8882",
            "fax_number": "832-237-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11811 FALLBROOK DR STE B-2",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770653507",
            "telephone_number": "832-237-8882",
            "fax_number": "832-237-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRADE",
        "first_name": "MARVIN",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-29",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA05379",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alison Andrade
• Amanda I. Andrade, M.D.
• Amanda Lea Andrade, OD
• Elibeth Andrade, LCSW
• Keerthan Andrade, APRN
• Michelle Lee Andrade, SLP
• Richard Gustilo Andrade, PHYSICAL THERAPIST
• Roberto Andrade, MD
• Sebastian Andrade, MD
• Vanessa Marie Andrade, AGACNP-BC

• Physician Assistant in Houston, TX
• Providers in Houston, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.