Individual provider Active NPI

Ignatius Andoh, PA

  • Student in an Organized Health Care Education/Training Program
  • Fort Sam Houston, TX
National Provider Identifier
1083254940
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
PA19662 Issued in TX
Practice address
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone
(210) 916-7500
NPI assigned
Jan 8, 2020
Last updated
Jul 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PA19662 TX Primary

Addresses

Primary practice location

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504

Mailing address

410 Nespral Dr
San Antonio, TX 78253-7587

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA19662TXMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1578441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1083254940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 NESPRAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782537587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDOH",
        "first_name": "IGNATIUS",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-08",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "PA19662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.